Woor ANNUAL REPORTS OF THE LATE MEDICAL OFFICERS OF HEALTH FOR WOOLWICH, PLUMSTEAD, AND ELTHAM, WITH PREFACE by the BOROUGH MEDICAL OFFICER, 1900. Metropolitan Borough of Woolwich Medical Officer of Health— SIDNEY DAVIES, M.A., M.D., D.P.H. Chief Sanitary Inspector— Albert G. Duck (Cert. San. Inst.). District Sanitary Inspectors— John W. Rance (Cert. San. Inst.), Dockyard and St. Mary's Wards. William Little (Cert. San. Inst.), Herbert and St. Margaret's Wards. Alfred G. Potter (Cert. San. Inst.), Burrage and River Wards. William Barnes (Cert. San. Inst.), St. Nicholas Ward. Adam Mackie (Cert. San. Inst.), Glyndon and Central Wards. William Woolley (Cert. King's College), St. George's „ William Wood (Cert. San. Inst.), Parish of Eltham. Inspectors under the Food and Drugs Act— W. Woolley, Parishes of Woolwich and Plumstead. W. Wood, Parish of Eltham. Public Health Committee Clerk— Charles Ellis. Assistant Clerk— Amyas Britter. A 2 INDEX. 1. Preface, giving vital statistics for Borough. 2. Professor Smith's Report for Woolwich. Index of Tables. Table I.—Deaths registered from all causes during the year 1900, in the Sanitary District of Woolwich classified according to Diseases and Ages, including deaths of non-parishioners occurring in various Institutions outside the district. „ II.—Comparative analysis and yearly average of the Mortality in Woolwich for the ten years 1890—1899; also for the year 1900. ,, III.—Comparative analysis and yearly average of births and deaths in the two sub-districts for the ten years 1890—1899; also for 1900. ,, IV.—Table of cases of Infectious disease in the Parish of Woolwich at various ages, classified according to diseases, in the year 1900. ,, V.—Table of deaths during the year 1900, in the parish of Woolwich, classified according to diseases and ages. ,, VI.—Return of the number of deaths of persons belonging to Woolwich occurring in various Institutions, &c., during the year 1900. ,, VII.—Registered deaths for each month in the Parish of Woolwich during the year 1900. „ VIII.—Comparative analysis of the vital and Mortal Statistics of Woolwich and 32 Provincial Towns during the year 1899. 3 Table IX.—Comparative analysis of the Mortal statistics of Woolwich and other Sanitary Districts of the Metropolis, during the year 1900. „ X.—Summary of Inquests held 1900. „ XI.—Registered births in 52 weeks of 1900 in the sub-districts. „ XIII.—Cases of Infectious disease notified to the several Metropolitan Medical Officers of Health in the year ended 29th December, 1900. ,, XIV.—Return of persons admitted into the temporary shelters during the years 1895 to 1900. ,, XV.—Return of the number of houses Inspected, notices served, &c., by the Sanitary Inspectors during the year 1900. ,, XVI.—List of Common Lodging Houses in Woolwich under the License of the London County Council. „ XVII.—List of Slaughter Houses and Cowsheds licensed by the London County Council in the Parish of Woolwich. ,, XVIII.—List of Bakehouses in the Parish of Woolwich in 1900. ,, XIX.—List of Houses registered under the late Board's Bye-laws made under the Public Health (London) Act, with respect to Houses let in Lodgings or occupied by members of more than one family. 3. Dr. Davies' Report for Plumstead. Index of Tables. Table I.—Population, Births and Deaths for whole District from 1890 to 1899, also for 1900, including deaths of non-residents in district, also deaths in Public Institutions in the district, and deaths of residents, registered beyond district. a 2 4 Table II.—Table of the births and deaths of the two divisions of East and West Plumstead during the four years 1896 to 1899, also for 1900. ,, III.—Cases of Infectious Disease notified during the year 1900. ,, IV.—Deaths at various ages, from different causes, corrected, for public institutions inside and outside the district. ,, V.—Death rate per 1000 persons on the population estimated to the middle of the year for the years 1890 to 1900, for various diseases. ,, VI.—Ages, Schools, and other particulars of the cases of Scarlet Fever and Diphtheria. ,, VII.—Summary of the vital statistics of Parish of Plumstead, 1885 to 1900. ,, VIII.—Analysis of the vital and mortal statistics of the Sanitary Districts of the Metropolis, after distribution of deaths occurring in Public Institutions during the year 1900. ,, IX.—Abstract from Mortuary Register 1900. ,, X.—Summary of nuisances abated, notices served, and general work of the Public Health Department for the 12 months ending 31st December, 1900. ,, XI.—Prosecutions under Public Health Department. ,, XII.—Particulars of Adulterations, and Results of Proceedings, 1st January, 1900, to 31st December, 1900. ,, XIII.—List of Enteric Fever Cases with particulars. „ XIV.—List of Bakehouses. „ XV.—Appendix I. Princes Road Area. ,, XVI.—Appendix II. Uncertified deaths and death Registration 4. Dr. Moore's Report for Eltham, 5 Preface to Annual Reports of the Medical Officers of Health, Woolwich, Plumstead, and Eltham, To the Mayor, Aldermen, and Councillors of the Metropolitan Borough of Woolwich. Mr. Mayor and Gentlemen, I have the honour to present to you the Annual Reports of Professor Smith for Woolwich Parish, of Dr. Moore for Eltham, and my own Report for Plumstead, for the year 1900. I may point out that Dr. Moore was under serious disadvantages in preparing his Report, having temporarily succeeded his father, the previous Medical Officer of Health for Eltham, who died suddenly in the autumn, and, consequently, not having full knowledge as to the statistics of the Parish. The population of the Borough, as found at the recent census, is 117,165. On the supposition that the increase since the previous census has been uniform, the population in the middle of 1900 was 115,490. Calculated from this basis, and figures given in each report, the Borough Birth Rate was 28.6, the Death Rate 17.8, and the Deaths under one year per 1,000 births 146. You did me the honour of appointing me Medical Officer of Health in November last, but my appointment was not confirmed till the 19th January, when I became responsible for the health of the Borough. The staff of the Health Department, as appointed by the Health Committee in January, is appended. 6 Mr. Wood has a separate office at Eltham, but is under the Chief Inspector, and in daily communication with this office. The work of organizing the Health Department for the Borough has been of considerable difficulty, and occupied a large amount of time on the part of the Chief Clerk, Chief Sanitary Inspector, and myself, but I am glad to say that it is now nearly accomplished, and the Sanitary Inspectors are working satisfactorily in their new districts. Insufficent office accommodation has seriously interfered with the duties of the officials, but the improved temporary accommodation will shortly be completed. I have to thank you, Mr. Mayor and Gentlemen, for the proof of your confidence in appointing me Medical Officer of this important Borough, and your kind response to my recommendations and requirements in reconstituting the Health Department. I have the honour to remain, Your obedient Servant, SIDNEY DAVIES. 7 THE Twelfth Annual Report of the Health, Sanitary Condition, etc., etc., of the PARISH OF WOOLWICH FOR THE YEAR 1900, by WILLIAM R, SMITH, M.D., DSc,, F.R.S.Ed., Barrister-at-Law, Professor of Forensic Medicine, King's College, London, MEDICAL OFFICER OF HEALTH. 8 Town Hall, Woolwich, January 12th, 1901. To the Mayor, Aldermen, and Councillors of the Borough of Woolwich. Gentlemen, I have the honour to submit my report upon the sanitary condition of the Parish of Woolwich during the year 1900. Mortality There have been 937 deaths during the year; of this number 403 occurred in the *Dockyard SubDistrict, and 534 in the Arsenal Sub-District. The gross death-rate for the year, estimated upon a population of 41,600 is 22.5 per thousand. Of these deaths 253 took place in various medical institutions (Table VI.) outside the district; in the appended statistical tables they have, however, been allotted to their proper subdistricts, and calculated as if taking place within the parish of Woolwich. Thirty deaths occurring within the district were of persons not rightly belonging to Woolwich ; if these be deducted from the total deaths the correct number of deaths occurring in Woolwich during the twelve months ending the 31st December, 1900, will be obtained, viz., 907. Death Rate. The net death-rate is therefore 21.8 per thousand. * The Registration sub-districts of Woolwich Dockyard and Woolwich Arsenal were combined on the 1st April, 1900. The whole parish is now known as Woolwich Sub-District for Registration purposes. 9 The following table shows the net death-rate yearly, since the appointment of a Medical Officer of Health for the parish on the 29th October, 1889 :— 1890 20.5 1891 21.6 1892 19.5 1893 19.7 1894 18.2 1895 17.4 1896 20.4 1897 17.3 1898 20.1 1899 21.0 1900 21.8 The death-rate for 1900 is thus seen to be higher than that of the preceding years, being the highest known since 1890. I have appended Tables Nos. VIII. and IX., which show the position taken by Woolwich in this respect as compared with other large towns and with the various Metropolitan Sanitary Districts. Of the total deaths 317 were of children under 5 years, and 620 of persons above that age; of the 317 children 203 were infants under one year of age. infants under one year of age. The infantile mortality is therefore 171 per thousand births :— Total Deaths. Deaths under one year. Deaths between the age of one and five years. 1890 838 215 141 1891 885 222 117 1892 806 198 95 1893 828 210 105 1894 755 177 113 1895 748 209 82 1896 860 224 163 1897 720 210 87 1898 870 220 142 1899 902 211 101 1900 937 203 114 10 Zymotic Death Rate. The deaths from all causes during the year included 29 from Measles, 6 from Scarlet Fever, 67 from Diarrhoea &c., 6 from Diphtheria, 16 from Whooping Cough, 3 from Enteric or Typhoid Fever, 29 from Influenza, 5 from Erysipelas, but none from Puerperal Fever; in all 161 deaths from diseases classified by the Registrar General as Specific Febrile, or Zymotic. This is equivalent to a Zymotic deathrate of 3.8 per thousand. This high rate is due to the increased mortality from Diarrhoea and Measles, the fatal cases of which numbered respectively 67 and 29, as compared with 47 and 13 in 1898. On the other hand deaths from Diphtheria are much below those in 1899, when their number was 21. Deaths from Scarlet Fever, Whooping Cough, and Erysipelas have risen from 12 and 2, to 6, 16 and 5 respectively. Enteric or Typhoid Fever and Influenza have fallen from 6 and 31 to 3 and 29. The Zymotic death-rate for the past ten years is as follows:— 1890 2.5 1891 2.8 1892 2.4 1893 2.6 1894 2.6 1895 1.8 1896 4.2 1897 2.7 1898 3.5 1899 3.4 1900 3.8 Phthisis Mortality, &c. In Table I., Class IV., 136 deaths are recorded as arising from some form of tubercular disease, of which number 48 occurred in the Dockyard Sub-District, and 11 88 in the Arsenal Sub-District. The corresponding figures in 1899 were 54 and 87 respectively. The deaths registered during the past nine years as arising from Tubercular causes were as follows :— 1892 112 1893 121 1894 126 1895 119 1896 124 1897 100 1898 118 1899 141 1900 136 By far the greater number of Deaths from Tubercular disease are due to Phthisis, as is shown by the following table :— Deaths from Deaths from other Phthisis. Tubercular Diseases. 1897. 1898. 1899. 1900. 1897. 1898. 1899. 1900. Dockyard District 32 45 43 31 5 16 11 17 Arsenal District 49 39 57 71 14 18 30 17 Totals 81 84 100 102 19 34 41 34 Of the total deaths from Tubercular diseases during 1900, 18 were of children under 5 years of age, and 118 of persons at ages of 5 and upwards. It will thus be seen that the total deaths from Phthisis for 1900 are the highest on record; other Tubercular diseases have fallen from 41, which was their total last year, to 34. Phthisis Death-Rate per 1,000 living. 1896. 1897. 1898. 1899. 1900. Dockyard District 1.9 1.6 2.3 2.2 1.6 Arsenal District 2.2 2.2 1.7 2.5 3.1 Totals 2.1 1.9 2.0 2.4 2.4 12 I would again point out that the want of provision to prevent dampness in many of the older houses in the district tends to perpetuate conditions that are favourable to the spread of tubercular diseases. Sex Mortality. Of the total deaths in the Dockyard Sub-District, there were 248 males and 155 females; in the Arsenal Sub-District 301 males and 233 females; or, in other words, of the 937 total deaths in the whole parish 549 were of males and 388 of females. Inquests & Suicides. There have been 95 Inquests during the year. There have been 7 Suicides as follows:—Shooting 3, Drowning 1, Cutting Throat 1, and Poisoning 2. Mortuary. Eighty bodies were received into the Old Mortuary Dock Rails of which 55 were of persons resident in the district and 25 non-resident. Thirteen were brought in by the Police, and 67 by undertakers, etc. The new Mortuary in Sun Street, which, together with the Disinfecting Shelter, was opened in November. Four bodies were received to the 31st December, 1900. *Births and Birth-Rate. The number of births registered during the year was 1175. Males 599 Females 576 1175 Of these 8 were recorded as illegitimate, 5 male and 3 female. The birth-rate, therefore, 28.2 per thousand, being the lowest recorded for nine years. * It has not been found possible to obtain separate statistics for the Arsenal and Dockyard sub-districts. (See foot-note, p. 1.) 13 For the past eight years the birth-rate has been as follows:— 1893 31.3 1894 30.5 1895 30.9 1896 30.5 1897 31.5 1898 30.2 1899 30.3 1900 28.2 Marriages. There have been 589 marriages registered during the year; in the first quarter 140, in the second 132, in the third 162, and in the fourth 155. Infectious Diseases. During the year 307 cases of infectious disease have been notified as follows (this number not including two second notifications):— Dockyard Sub-District. Arsenal Sub-District. Total. Small-pox 2 – 2 Scarlet Fever 61 73 134 Typhus — — — Relapsing Fever — — — Diphtheria 46 60 106 Membranous Croup 1 0 1 Continued Fever — — — Typhoid or Enteric Fever 2 21 23 Cholera — — — Erysipelas 13 26 39 Puerperal Fever — 2 2 Totals 125 182 307 Of these 307 cases 224 were removed to Hospital as follows:— Dockyard Sub-District. Arsenal Sub-District. Total. Small-pox 2 – 2 Scarlet Fever 54 60 114 Diphtheria 42 45 87 Membranous Croup — — – Typhoid or Enteric Fever 2 15 17 Erysipelas 3 1 4 Puerperal Fever — — — Totals 103 121 224 14 In other words, the following cases were treated at home:— Dockyard Sub-District Arsenal Sub-District. Total. Scarlet Fever 7 13 20 Diphtheria 4 15 19 Membranous Croup 1 — 1 Typhoid or Enteric Fever — 6 6 Erysipelas 10 25 35 Puerperal Fever — 2 2 Totals 22 61 83 It is satisfactory to note the smaller number of cases of Scarlet Fever and Diphtheria treated at home this year, showing an appreciation on the part of the inhabitants of the advantages of hospital accommodation. The total number of cases of notifiable Infectious Diseases during the year is the lowest for four years. The following table will show the prevalence of the principal Zymotic diseases during the past seven years:— 1894 1895 1896 1897 1898 1899 1900 Small-pox 15 1 1 2 — 1 2 Scarlet Fever 215 187 144 225 204 168 134 Diphtheria 49 67 99 150 107 142 106 Typhoid or Enteric Fever 14 50 21 18 22 27 23 Totals 293 305 265 395 333 338 265 Small-pox. Two cases notified in February were promptly removed to Hospital. One ended fatally. Careful enquiries failed to trace any cause. Scarlet Fever. The number of Scarlet Fever notifications for the year was the lowest for eight years. Fortyone of the cases were children under 5 years of age. 15 Diphtheria. There is a decrease in the number of cases (being the lowest since 1896.) Enteric or Typhoid Fever. Twenty-three notifications were received, being a slight decrease in the number received during 1899, but still somewhat higher than in the three preceding years. In October and November 10 cases in 16 days were notified at North Woolwich. The drainage in most of the houses was opened up and found defective. On reference to the Returns of the Metropolitan Asylums Board (see Table XIII) we get the notifications of the principal infectious diseases received by that Board for the corresponding seven years from the whole of London :— 1894 1895 1896 1897 1898 1899 1900 Small-pox 1192 979 225 105 32 29 Scarlet Fever 10655 19757 25647 22876 16894 18112 Diphtheria 18440 10772 13362 12811 11543 13365 Typhoid or Enteric Feve r 3360 3506 3190 3113 3024 4458 It will be seen that whilst there are more notifications from Scarlet Fever, Diphtheria, and Enteric Fever, than in 1898, Scarlet Fever is considerably less than in 1897, and Small-pox has decreased yearly. Disinfection. During the year 236 houses and 4405 articles of clothing, bedding, etc., have been disinfected. Temporary Shelter. Three families, represented by 10 persons, were admitted to the old Shelter, 162, Samuel Street, to the end of October, and two families represented by five persons to the New Shelter, Sun Street, during November and December, 16 House to House Inspection. During the year the Inspectors have visited 4104 houses, and made 2436 re-inspections, these inspections necessitating the issuing of 1279 notices. Common Lodging Houses. There are 37 common lodging houses in the district. The control of these houses is under the London County Council. They continue to be well conducted, and the proprietors are willing to co-operate in every way with the Sanitary Officials. Slaughter Houses. There are 6 licensed slaughter-houses in the district. The regulations of the London County Council applying to them are generally observed. I would repeat the hope I expressed in my last Report that, in the interests both of the trade and the public, they will at no distant time be all done away with and replaced by a Public Abattoir under the control of the Local Authority. Bakehouses. These have, during the year been systematically visited to secure compliance with the regulations. There are now 40 in the district. The structural defects in many of them are serious, but legal difficulties present a great obstacle in the way of attempting to abolish them. Underground Rooms. With regard to underground rooms generally, due attention continues to be directed to them, and the regulations on the subject are strictly enforced. Houses let in Lodgings. There are 66 houses registered under the Byelaws (Table XIX.), and inspections have been systematically made to ensure compliance with the regulations. Rag and Bone Shops. These have been regularly visited, and have called for no special action on the part of the officials, 17 Cow Sheds, Milk Shops, &c. There is only 1 licensed cow-shed in the district; this, together with the milk shops, etc., has been subjected to constant supervision. The Market. The market has been systematically visited both by night and day. As I have remarked on previous occasions, the meat exposed for sale is at times of somewhat inferior quality. Dust Collection. The pail system continues to work most satisfactorily. The dust is removed weekly from every house in the district, and from some of the streets in the poorer parts of the town twice or thrice weekly. The Destructor provided by the late Board continues to work in a most satisfactory manner both by night and day. PublicHealth London), 1891, Act. Various proceedings taken under this Act during the year, principally in consequence of notices not being complied with. Housing of the Working Classes Act. The actions taken with regard to this measure during the year were two houses re-opened in rear of Henry Street, and a block of four cottages near Woolwich Road closed as unfit for habitation. The baths continue to be extensively used, no less than 133,691 bathers having made use of them during the season. The greatest number of bathers in one week was 8893. Sanitary and other Improvements. The following are the principal sanitary improvements to be recorded during the past year:— 1. The opening of an underground convenience for both sexes at the Nile Street approach to the Woolwich Free Ferry. 2. The completion of the new Mortuary and Disinfecting Shelter in Sun Street. b 18 3. The rebuilding of the houses in the district is being continued, Hare Street, Powis Street, etc., being practically rebuilt. 4. The completion of the pumping station and reservoirs, etc., and the construction of the main sewer in connection with Woolwich Drainage, the whole scheme of which is complete as far as the parish boundary is concerned. I have, in conclusion, to acknowledge my indebtedness to the Committee for their continued support, and to the Sanitary Inspectors for their loyal co-operation and the conscientious discharge of their respective duties. To Mr. J. A. Arnold, the Clerk of the Department, my thanks are especially due for the very able manner in which he has discharged his duties. I am, Gentlemen, Your obedient servant, WILLIAM E. SMITH, M.D., Medical Officer of Health. 19 TABLE I. Deaths Registered from all causes in the Year 1900, in the Parish of Woolwich, including Deaths of Non-Parishioners, also Deaths of Parishioners occurring in various Public Institutions outside the District. Cause of Death. Ages. Totals under 5 years. Totals 5 years and upwards. Grand Totals at all ages. sub-district. Under 1 Year. 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 & upwards Dockyard. Arsenal. (Classes.) I. Specific Febrile or Zymotic Diseases 70 44 9 10 6 1 4 9 6 9 2 114 56 170 76 94 II Parasitic Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. III. Dietetic Diseases .. .. .. .. 3 2 2 .. 1 .. .. .. 8 8 6 2 IV. Constitutional Diseases 3 16 11 16 27 36 23 24 7 5 .. 19 149 168 64 104 V. Developmental Diseases 26 .. .. .. .. .. .. .. 1 12 12 26 25 51 21 30 VI. Local Diseases 73 49 14 26 33 45 55 69 63 32 6 122 343 465 209 256 VII. Deaths from Violence 4 4 4 4 3 5 9 5 1 2 1 8 34 42 14 28 VIII. Deaths from Ill-defined and Nonspecified Causes 27 1 .. .. 1 2 1 .. 1 .. .. 28 5 33 13 20 Totals 203 114 38 56 73 91 94 107 80 60 21 317 620 937 403 534 b 2 20 Table I.—Continued. Cause of Death. Ages. Totals under 5 years. Totals 5 years and upwards. Grand Totals at all ages. sub-district. Under 1 Year. l to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 & upwards. Dockyard. Arsenal. I.—Specific Febrile or Zymotic Diseases 1.—Miasmatic Diseases. Small Pox Vaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Unvaccinated .. .. .. 1 .. .. .. .. .. .. .. .. 1 1 1 .. Not Stated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 9 18 2 .. .. .. .. .. .. .. .. 27 2 29 13 16 Scarlet Fever 1 3 2 .. .. .. .. .. .. .. .. 4 2 6 1 5 Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough 8 8 .. .. .. .. .. .. .. .. .. 16 .. 16 5 11 Diphtheria .. 2 3 1 .. .. .. .. .. .. .. 2 4 6 2 4 Simple, Continued, or Ill-defined Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric or Typhoid Fever .. 1 .. 1 .. 1 .. .. .. .. .. 1 2 3 2 1 Influenza 1 1 1 3 3 .. 4 4 3 7 2 2 27 29 18 11 Other Miasmatic Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2.- Diarrhæal Diseases. Simple Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea, Dysentery 49 11 .. 1 1 .. .. 2 2 1 .. 60 7 67 28 39 3.—Malarial Diseases. Remittent Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4.—Zoogenous Diseases. Cow Pox and Effects of Vaccination .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases (e.g., Hydrophobia, Glanders, Splenic Fever) .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 1 .. 5. —Venereal Diseases. Syphilis 1 .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. 1 Gonorrhoea, Stricture of the Urethra .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6.—Septic Diseases. Erysipelas .. .. .. 1 1 .. .. 2 1 .. .. .. 5 5 2 3 Pyaemia and Septicæmia 1 .. 1 2 .. .. .. 1 .. 1 .. 1 5 6 3 3 Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 21 Table I.—Continued. Cause of Death. Ages. Totals under 5 years. Totals 5 years and upwards. Grand Totals at all ages. sue-district. Under 1 Year. 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 & upwards. Dockyard. Arsenal. II.—Parasitic Diseases. Thrush and other Vegetable Parasitic Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Worms, Hydatids, and other Animal Parasitic Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. III.—Dietetic Diseases. Want of Breast Milk—Starvation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chronic Alcoholism .. .. .. .. 2 2 2 .. 1 .. .. .. 7 7 5 .. Delirium Tremens .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 1 .. IV.—Constitutional Diseases. Rheumatic Fever, Rheumatism of Heart .. .. .. .. .. .. 1 .. 2 .. .. .. 3 3 3 .. Rheumatism .. .. .. 1 1 1 .. .. .. .. .. .. 3 3 1 2 Gout .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Riokets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cancer, Malignant Diseases .. .. .. .. 1 3 3 8 3 4 .. .. 22 22 9 13 Tabes Mesenterica 1 .. .. .. .. .. .. .. .. .. .. 1 .. 1 1 .. Tubercular Meningitis Hydrocephalus 1 5 1 .. .. .. .. .. .. .. .. 6 1 7 4 3 Phthisis .. .. 3 10 25 29 19 13 2 1 .. .. 102 102 31 71 Other forms of Tuberculosis, Scrofula 1 11 6 4 .. 3 .. 2 .. .. .. 12 15 27 13 14 Purpura, Hæmorrhagic Diathesis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anaemia, Chlorisis, Leucocythæemia .. .. .. 1 .. .. .. .. .. .. .. .. 1 1 .. 1 Glycosuria, Diabetes Mellitus .. .. 1 .. .. .. .. 1 .. .. .. .. 2 2 2 .. Other Constitutional Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. V.—Developmental Diseases. Premature Birth 20 .. .. .. .. .. .. .. .. .. .. 20 .. 20 6 14 Atelectasis 4 .. .. .. .. .. .. .. .. .. .. 4 .. 4 1 3 Congenital Malformation 2 .. .. .. .. .. .. .. .. .. .. 2 .. 2 1 1 Old Age .. .. .. .. .. .. .. .. 1 12 12 .. 25 25 13 12 22 Table I.—Continued. Cause of Death. Ages. Totals under 5 years. Totals 5 years and upwards. Grand Totals at all ages. sub-district. Under| 1 Year. 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 & upwards. Dockyard. Arsenal. VI.—Local Diseases. 1.—Diseases of the Nervous System. Inflammation of Brain or Membrane 5 6 4 3 1 .. .. 2 .. .. .. 11 10 21 14 7 Apoplexy, Softening of Brain, Hemiplegia, Brain Paralysis 1 1 .. 1 3 4 8 6 10 3 .. 2 35 37 18 19 Insanity, General Paralysis of the Insane .. .. .. .. 2 2 .. 1 .. .. .. .. 5 5 2 3 Epilepsy .. .. .. .. 2 1 1 1 .. .. .. .. 5 5 1 4 Convulsions 25 4 .. .. .. .. .. .. .. .. .. 29 .. 29 18 11 Laryngismus Stridulus (Spasm of Glottis) 2 .. .. .. .. .. .. .. .. .. .. 2 .. 2 .. 2 Disease of Spinal Cord, Paraplegia, Paralysis Agitans .. .. .. 1 .. .. .. 2 1 1 .. .. 5 5 1 4 Other Diseases of the Nervous System .. 1 .. .. 2 .. .. .. .. .. .. 1 2 3 1 2 2.—Diseases of the Organs of Special Sense (e.g., of Ear, Eye, Nose) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3.—Diseases of Circulatory System. Pericarditis .. .. .. 1 .. .. .. .. .. .. .. .. 1 1 1 .. Acute Endocarditis .. .. .. .. 1 1 .. .. .. .. .. .. 2 2 2 .. Valvular Disease of the Heart .. .. 2 2 2 1 5 4 1 1 .. .. 18 18 7 11 Other Diseases of the Heart .. 2 2 2 4 6 13 9 15 12 1 2 64 66 31 35 Aneurism .. .. .. .. 1 .. 1 3 .. .. .. .. 5 5 2 3 Embolism, Thrombosis .. .. .. .. .. .. .. 1 2 .. .. .. 3 3 .. 3 Other Diseases of Blood Vessels .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4.—Diseases of Respiratory System. Laryngitis .. .. .. 1 .. .. .. .. .. .. .. .. 1 1 1 Croup .. 1 .. .. .. .. .. .. .. .. .. 1 .. 1 1 .. Emphysema, Asthma .. .. .. .. 1 .. 2 .. 1 1 .. .. 5 5 4 1 Bronchitis 15 8 1 .. 1 1 5 9 24 8 3 23 52 75 31 44 Pneumonia 13 16 2 11 3 15 10 10 3 1 .. 29 55 84 44 40 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of the Respiratory System. 2 2 .. 1 .. 1 .. l .. 1 .. 4 4 8 2 6 23 Table I.—Continued. Cause of Death. Ages. Totals under 5 years. Totals 5 years & upwards Grand Totals at all ages. sub-district. Under 1 Year. 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 & upwards Dock yard. Arsenal VI.—Local Diseases.—(Contd.) 5.—Diseases of Digestive System. Dentition 1 2 .. .. .. .. .. .. .. .. .. 3 .. 3 1 2 Sore Throat, Quinsy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Stomach 2 2 .. 2 1 1 .. 1 .. .. .. 4 5 9 3 6 Enteritis 5 2 .. .. .. .. .. 2 2 .. 1 7 5 12 4 8 Obstructive Diseases of Intestines .. 1 1 .. .. .. .. 2 1 .. .. 1 4 5 1 4 Peritonitis .. .. 1 .. 1 1 .. .. .. 1 .. .. 4 4 2 2 Ascites .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 .. 1 Cirrhosis of Liver .. .. .. .. 2 2 5 7 .. .. .. .. 16 16 6 10 Jaundice and other Diseases of Liver 1 .. .. .. .. 2 .. .. .. 1 1 1 4 5 1 4 Other Diseases of Digestive System .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6.—Diseases of Lymphatic System. (e.g., of Lymphatic Vessels, Glands & Spleen) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 7.—Diseases of Gland-like Organs of uncertain use. (e.g., Bronchocele, Addison's Disease) .. .. .. .. .. .. .. .. 1 .. .. .. 1 1 .. 1 8. —Diseases of the Urinary System. Nephritis .. 1 1 1 3 3 1 4 .. .. .. 1 13 14 6 8 Bright's Disease, Albuminuria .. .. .. .. .. 1 3 3 2 1 .. .. 10 10 2 8 Disease of Bladder or of Proscate .. .. .. .. .. .. .. .. .. 1 .. .. 1 1 1 .. Other Diseases of Urinary System 1 .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. 1 9.—Diseases of the Reproductive System. A. of Organs of Generation. Male Organs .. .. .. .. .. .. 1 1 .. .. .. .. 2 2 1 1 Female Organs .. .. .. .. 1 2 .. .. .. .. .. .. 3 3 1 2 B. of Parturition. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Abortion, Miscarriage .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Convulsions .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Placenta Præia, Flooding .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Accidents in Childbirth .. .. .. .. 1 1 .. .. .. .. .. .. 2 2 .. 2 10.—Diseases of Bones and Joints. Caries, Necrosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Arthritis, Osteitis, Periostitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Bones and Joints .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 11.—Diseases of the Integumentary System. Carbuncle, Phlegmon .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases of Integumentary System .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 24 Table 1.—Continued. Cause of Death. Ages. Totals under 5 Years. Totals 5 years and upwards. Grand Totals at all ages. sub-district. Under 1 Year. 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 & upwards. Dockyard. Arsenal. VII.—Deaths from Violence. 1.—Accident or Neglect. Fractures and Contusions 1 1 2 1 2 2 2 3 1 2 1 2 16 18 7 11 Gunshot Wounds .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cut, Stab .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Burn, Scald 1 3 1 .. .. .. .. .. .. .. .. 4 1 5 2 3 Poison .. .. .. .. .. .. .. .. .. .. .. .. 1 1 1 .. Drowning .. .. .. .. .. .. 4 .. .. .. .. .. 7 7 1 6 Suffocation 2 .. .. .. .. .. 2 .. .. .. .. 2 2 4 .. 4 Otherwise .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2.—Homicide. Manslaughter .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Murder .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3.—Suicide. Gunshot Wounds .. .. .. 2 1 .. .. .. .. .. .. .. 3 3 1 2 Cut, Stab .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 .. 1 Poison .. .. .. .. .. 1 .. 1 .. .. .. .. 2 2 1 1 Drowning .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hanging .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Otherwise .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 1 .. 4.—Execution. Hanging .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. VIII.—Deaths from Ill-Defined but Non-Specified Causes. Dropsy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Debility, Atrophy, Inanition 27 1 .. .. .. .. .. .. .. .. .. 28 .. 28 12 16 Mortification .. .. .. .. .. .. .. .. 1 .. .. .. l 1 1 .. Tumour .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Abscess .. .. .. .. 1 .. .. .. .. .. .. .. l 1 .. 1 Hæmorrhage .. .. .. .. .. 1 1 .. .. .. .. .. 2 2 .. 2 Sudden Death (cause not ascertained) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Causes not Specified or Ill-defined .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 .. 1 Grand Totals for Woolwich 203 114 38 56 73 91 94 107 80 60 21 317 620 937 403 534 25 Table II. Being Table I. required by the Local Government Board. Name of District—Woolwich. For whole District. Year. 1 Population estimated to Middle of each year. 2 Births. Deaths under One Year of Age. Deaths at all Ages. Total. Deaths in Public Institutions. 9 Deaths of Nonresidents Registered in District. 10 Deaths of Residents Registered beyond District. 11 Deaths at all Ages. Nett. Number. 3 Rate* 4 Number. 5 Rate per 1000 Births Registered. 6 Number 7 Rate* 8 Number. 12 Rate* 13 1890 40800 1241 30.6 215 17.3 874 21.4 180 36 180 838 20.5 1891 40848 1336 32.7 222 16.6 917 22.4 197 32 197 885 21.6 1892 41348 1236 29.9 198 16.0 836 20.2 192 30 192 806 19.5 1893 41854 1312 31.3 210 16.0 848 20.2 176 20 176 828 19.7 1894 41417 1265 30.5 178 14.3 769 18.5 190 14 190 755 18.2 1895 42768 1323 30.9 209 15.8 771 18.0 181 23 181 748 17.4 1896 41338 1283 30.5 224 17.5 879 20.9 192 19 192 860 20.4 1897 41430 1306 31.5 210 16.0 748 180 177 28 177 720 17.3 1898 41478 1253 30.2 220 17.5 870 20.9 221 35 221 835 20.1 1899 41542 1260 30.3 211 16.7 902 21.7 240 31 240 871 21.0 Averages for years 1890—1899 41481 1283 30.9 209 16.2 841 20.2 194 27 194 814 19.6 1900 41600 †1175 28.2 203 17.1 684 16.4 253 30 253 907 21.8 Note.—The deaths to be included in Column 7 of this Table are the whole of those Registered during the year as having actually occurred within the District or Division. The deaths to be included in Column 12 are the number in Column 7, corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the term " Non-residents " is meant persons brought into the district on account of illness, and dying there ; and by the term " Residents " is meant persons who have been taken out of the district on account of illness, and have died elsewhere Area of District in acres (exclusive of area covered by water), 1,126. Total Population at all ages Number of Inhabited Houses Average number of Persons per House 40,848 5,496 7.4 At Census of 1891. *Rates calculated per 1,000 of Estimated Population. †8 of these were Illegitimate, 5 males, and 3 females. 26 Table III. Being Table II. required by the Local Government Board. Name of Distbict.—Woolwich. Names of Localities. Dockyard Sub-District. Arsenal Sub-district. Year. Population estimated to middle of each Year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. a b c d a b c d 1890 19612 565 370 92 21188 676 501 123 1891 19606 609 390 107 21242 727 527 115 1892 19876 529 398 86 21472 707 438 112 1893 20109 580 401 97 21745 732 447 113 1894 1S890 509 326 79 21527 756 443 99 1895 20492 570 340 92 22276 753 431 117 1896 19343 547 392 100 21995 736 487 124 1897 19292 544 317 90 22138 762 431 120 1898 19310 522 382 105 22168 731 488 115 1899 19153 531 384 88 22389 729 518 123 Averages of Years 1890 to 1899. 19658 550 370 93 21814 734 471 116 1900 19177 • 403 85 22423 • 534 118 Notes.—(a) The separate localities adopted for this table should be areas of which the populations are obtainable from the census returns, such as wards, parishes or groups of parishes, or registration sub-districts. Block 1 may if desired, be used for the whole district, and blocks 2, 3, &c., for the several localities. In small districts without recognised divisions of known population this table need not be filled up. (b) Deaths of residents occurring beyond the District are to be included in sub-columns c of this table, and those of nonresidents registered in the district excluded. (See note on Table I. as to meaning of terms "resident" and "nonresident.") (c) Deaths of residents occurring in public institutions are to be allotted to the respective localities, according to addresses of the deceased. * Sub-districts are now combined and show no separate birth-rate. 27 Table IV., Being Table III. required by the Local Government Board. Woolwich District. Gases of Infectious Disease notified during the Year 1900. Notifiable Disease. Cases Notified in Whole District. Total Cases notified in each Locality. No. of Cases removed to Hospital from each Locality. At all Ages. At Ages—Years. 1 Dockyard SubDistrict. 2 Arsenal SubDistrict. 1 Dockyard SubDistrict. 2 Arsenal SubDistrict. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards Small-pox 2 .. .. .. 1 1 .. 2 .. 2 .. Cholera .. .. .. .. .. .. .. .. .. .. .. Diphtheria 106 3 25 49 24 5 .. 46 60 42 45 Membranous Croup 1 .. 1 .. .. .. .. 1 .. .. Erysipelas 39 1 .. 1 5 28 .. 13 26 3 1 Scarlet Fever 134 .. 41 74 16 3 .. 61 73 54 60 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 23 .. 1 4 7 11 .. 2 21 2 15 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 2 .. .. .. 1 1 .. .. 2 .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 307 4 68 128 54 49 4 125 182 103 121 Notes.—The localities adopted for this table should be the same as those in Tables II. and IV. State the name of the isolation hospital, if any, used by the sick of the district. Mark (H) the locality in which it is situated, or if not within the district state where it is situated and in what district. This space may be used for record of other disease the notification (compulsory or voluntary) of which is in force in the district. These age columns for notifications should be filled up in all cases where the Medical Officer of Health, by inquiry or otherwise, has obtained the necessary information. TABLE V., Being Table IV. required by the Local Government Board. Woolwich District. Causes of, and Ages at, Death during Year 1900. Causes of Death. Deaths in whole District at subjoined Ages. Deaths in Localities (at all ages). Deaths in Public Institutions. All Ages Under 1 1 and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards Dkyd. SubDist. Arsnl. SubDist. Small Pox .. .. .. .. 1 .. .. 1 .. 1 Measles 29 9 18 2 .. .. .. 13 16 .. Scarlet Fever 6 1 3 2 .. .. .. 1 5 6 Whooping Cough 16 8 8 .. .. .. .. 5 11 .. Diphtheria and Membranous Croup 6 .. 2 3 .. .. .. 2 4 6 Croup 1 .. 1 .. .. .. .. 1 .. .. Typhus Fever Enteric Other continued 3 .. 1 .. 1 1 .. 2 1 3 Epidemic Influenza 29 1 1 1 3 11 12 18 11 8 Cholera .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. Diarrhœa (See notes at back) 67 49 11 .. .. 3 3 28 39 3 Enteritis (See notes at back) 12 5 2 .. .. 2 3 4 8 2 Puerperal Fever .. .. .. .. .. .. .. .. .. .. Erysipelas 5 .. .. .. 1 3 1 2 3 2 28 Table V.—continued. Causes of Death. Deaths in whole District at subjoined Ages. Deaths in Localities (at all ages). Deaths in Public Institutions. All Ages Under 1 1 and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards Dkyd. Sub- Dist. Arsnl. SubDist. Other Septic Diseases 6 1 .. 1 2 1 1 3 3 3 Phthisis 102 .. .. 3 10 86 3 31 71 67 Other Tubercular Diseases 34 2 16 7 4 5 •• 17 17 11 Cancer, malignant disease 22 • • •• •• •• 15 7 9 13 8 Bronchitis 75 15 8 1 •• 16 35 31 44 11 Pneumonia 84 13 16 2 11 38 4 44 40 22 Pleurisy .. .. .. .. .. .. .. .. .. •• Other Diseases of Respiratory Organs 14 2 2 .. 2 5 3 6 8 3 Alcoholism Cirrhosis of Liver 24 .. .. .. .. 23 1 12 12 3 Venereal Diseases 1 1 .. .. .. .. •• •• 1 •• Premature Birth 20 20 .. .. •• •• •• 6 14 1 Diseases and Accidents of Parturition 2 .. .. .. .. 2 •• •• 2 •• Heart Diseases 84 .. 2 4 4 44 30 38 46 19 Accidents 35 4 4 4 2 17 4 11 24 11 Suicides 7 • • •• • • 2 5 •• 3 4 2 All other causes 253 72 19 8 .. 88 55 115 138 61 All causes 937 203 114 38 56 365 161 403 534 253 29 30 Table VI. Return of the number of Deaths of Persons belonging to Woolwich, occurring in various Institutions, etc., during the year 1900. Names of Institutions, Etc. Number of Deaths. Remarks M. F. Totals Station House, Rochester Row 1 .. 1 St. Peter's Home, Kennington .. 1 1 Freidenheim .. 1 1 Brook Fever Hospital 10 7 17 Cancer Hospital .. 1 1 Charing Cross Hospital .. 2 2 Cheyne Hospital .. 1 1 Children's Hospital, Great Ormond Street .. 1 2 Children's Hospital, Shadwell .. 1 1 Guy's Hospital 4 2 6 Herbert Hospital 32 .. 32 Hospital Ship " Atlas " .. 1 1 King's College Hospital 1 .. 1 London Hospital 2 3 5 Middlesex Hospital 1 .. 1 Miller Hospital 1 .. 1 Park Fever Hospital .. 1 1 Poplar Hospital .. l 1 Seamen's Hospital 1 .. 1 St. Bartholomew's Hospital l .. 1 St Thomas's Hospital l 1 5 Spanish and Portugese Hospital, Mile End .. l 1 Banstead Asylum 2 l 3 Cane Hill Asylum 1 .. 1 Caterkam Asylum 2 1 3 Darenth Asylum 1 l 2 Ilford Asylum .. l 1 Leavesden Asylum 1 1 2 Manor Asylum .. 1 1 Peckham House Asylum 1 .. 1 Woolwich Union Infirmary 100 55 155 Totals 164 89 253 31 Table VII. Registered Deaths for each Month in the Parish of Woolwich during the Year 1900. Month. Dockyard Sub-District. Arsenal Sub-District. Totals. Grand Totals of Dockyard and Arsenal M. F. Totals M. F. Totals M. F. January 24 30 54 41 27 68 65 57 122 February 22 14 36 21 27 51 46 41 87 March 23 10 33 22 17 39 45 27 72 April 17 14 31 34 22 56 51 36 87 May 25 7 32 28 23 51 53 30 83 June 19 11 30 16 13 29 35 24 59 July 19 7 26 17 16 33 36 23 59 August 36 15 51 42 31 73 78 46 124 September 18 12 30 34 17 51 52 29 81 October 14 15 29 15 10 25 29 25 54 November 10 12 22 13 17 30 23 29 52 December 21 8 29 15 13 28 36 21 57 Totals 248 155 403 301 233 534 549 388 937 32 Table VIII. Aualysis of the Vital and Mortal Statistics of the Sanitary Districts of the Metropolis, after Distribution of Deaths occurring in Public Institutions during the year 1900. Sanitary Areas. Estimated Population middle of 1900. Births. Deaths. Annual Rate per 1000 living. Deaths from Principal Zymotic Diseases Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus. Enteric Fever. Simple and undefined Fever. Diarrhœa. Phthisis. Deaths of Children under 1 year of age to 1000 births. Births. Deaths. Principal Zymotic Diseases. London 4,589,129 130,868 83,732 28.6 18.3 2.19 10,034 4 1,928 361 1,539 1,945 2 716 7 3,532 7,809 158 West Districts. Paddington 130,134 2,891 2,069 22.3 15.9 1.72 222 — 50 5 27 35 1 8 1 95 149 165 Kensington 173,603 3,586 2,730 20.7 15.8 1.66 286 — 98 4 27 33 — 17 107 204 180 Hammersmith 110,203 2,994 1,887 27.2 17.2 2.23 247 — 90 7 28 10 — 17 95 185 162 Fulham 136,383 4,524 2,350 33.3 17.3 2.86 387 — 81 23 66 54 — 18 145 210 147 Chelsea 96,715 2,235 1,732 23.2 18.0 1.77 170 — 33 7 18 18 — 19 75 165 149 St. George's,Hanover Sq. 81,133 1,295 1,119 16.0 13.8 0.78 63 — 6 6 11 11 1 11 17 110 107 Westminster 51,657 1,058 1,062 20.5 20.6 1.46 75 — 20 1 8 15 — 9 22 124 189 St. James', Westminster North Districts. 21,457 409 344 19.1 16.1 1.08 23 — 6 1 4 2 — 3 7 35 154 Marylebone 139,777 3,991 2,627 28.6 18.9 1.86 259 2 49 12 40 55 — 12 1 88 278 125 Hampstead 81,766 1,621 922 19.9 11.3 1.18 96 — 21 4 31 9 — 9 22 69 100 St. Pancras 245,651 6,447 4,639 26.3 18.9 2.35 580 — 126 10 72 105 — 64 1 202 472 160 Islington 351,541 9,253 5,723 26.4 16.3 1.90 667 .161 25 105 147 — 49 1 178 556 145 Stoke Newington 35,718 775 449 21.8 12.6 1.43 51 — 2 4 14 11 — 6 14 37 108 Hackney 225,519 6,373 3,624 28.3 16.1 2.11 476 — 33 19 59 112 — 43 210 260 158 Central Districts. St. Giles 36,870 1,017 671 27.7 18.2 1.67 61 — 11 4 8 14 5 19 110 118 St. Martin-in-the-Fields 11,865 155 209 13.1 17.7 0.84 10 — — — 2 1 — 3 4 28 148 Strand 22,748 445 464 19.6 20.5 1.14 26 — 5 1 3 5 4 8 74 135 Holborn 29,188 732 770 25.2 26.5 2.37 69 — 21 4 5 11 — 4 24 83 240 Clerkenwell 66,007 1,963 1,413 29.8 21.5 2.71 179 — 39 10 18 52 — 6 54 169 167 St. Luke 40,655 1,821 1,085 44.9 26.8 3.25 132 — 30 2 13 35 — 6 46 128 138 London City 26,922 397 591 14.8 22.0 0.89 24 — 4 5 6 3 — 2 4 67 176 East Districts. Shoreditch 120,641 4,004 2,604 33.3 21.6 3.02 364 — 76 16 57 48 — 14 1 152 224 186 Bethnal Green 128,831 4,588 2,822 35.7 22.0 2.76 355 — 63 12 63 94 — 18 105 272 168 Whitechapel 82,220 2,902 1,589 35.4 19.4 1.73 142 — 31 11 19 23 — 9 49 189 139 St. George-in-the-East 48,875 2,175 1.187 44.6 24.4 2.61 127 — 20 6 14 27 — 10 50 128 162 Limehouse 58,944 1,839 1,534 31.3 26.1 4.10 241 — 83 13 17 56 — 7 65 145 228 Mile End Old Town 113,781 4,261 2,311 37.6 20.4 2.53 288 — 60 7 35 58 — 22 106 193 158 Poplar 170,968 5,923 3,803 34.7 22.3 3.34 569 — 78 8 115 104 — 47 217 305 192 South Districts. St. Saviour Southwark 23,854 700 600 29.4 25.2 2.93 70 — 10 — 15 12 — 6 27 74 197 St. George Southwark 60,597 2,093 1,652 34.6 27.3 3.53 213 — 36 11 23 43 — 12 88 221 209 Newington 125,138 4,173 2,727 33.4 21.9 2.85 355 — 70 11 70 65 — 21 118 276 171 St. Olave Southwark 10,909 400 231 36.8 21.2 1.85 20 — 5 1 3 8 — _ 3 29 120 Bermondsey 85,920 2,826 1,948 33.0 22.7 3.24 277 — 42 7 59 64 — 27 78 169 186 Rotherhithe 41,246 1,184 883 28.8 21.5 3.40 140 — 40 6 26 22 — 10 36 47 205 Lambeth 312,152 9,167 5,431 29.4 17.4 1.66 519 — 69 21 101 98 — 53 1 176 521 145 Battersea 178,100 5,161 2,985 29.1 16.8 2.34 415 — 78 11 34 108 — 32 152 262 159 Wandsworth 217,004 5,774 3,204 26.7 14.8 1.65 361 — 82 17 44 44 — 27 1 146 252 144 Camberwell 268,457 7,211 4,372 26.9 16.3 1.99 534 — 40 12 132 122 — 33 195 370 154 Greenwich 184,582 5,562 3,305 30.2 18.0 2.27 418 — 58 15 64 111 — 23 147 274 161 Lee 40,722 990 615 24.4 15.1 1.40 57 — 5 — 19 9 — 4 20 39 156 Lewisham 93,548 2,784 1,469 29.8 15.7 2.14 200 — 20 9 32 49 — 14 76 104 131 Plumstead 65,558 1,994 1,065 30.5 16.3 2.30 150 — 47 7 25 27 — 9 35 96 129 Woolwich 41,600 1,175 937 28.3 21.8 2.79 116 1 29 6 6 16 3 67 102 171 Note.—The changes made under the provisions of the London Government Act, 1899, are not taken into account in the above table in order that uniform statistics for the year may be shown. 33 INQUESTS 1900. During the year, the Coroner, in 95 cases, held Inquests with the following results :— I.— NATURAL CAUSES 59 II.- -ACCIDENTAL CAUSES: Burns 4 Drowning 3 Falls, &c. 5 Fractures 3 Misadventure 1 Run over 6 Suffocation 4 26 III. —HOMICIDAL CAUSES: Suicide 7 Murder, Manslaughter 0 7 IV.- -OPEN VERDICTS: Found drowned 3 Found dead 0 3 Total 95 34 Table XI. Registered Births in Fifty-two Weeks of 1900 in the Parish of Woolwich. Month. Legitimate. Illegitimate. Totals. Totals. M. F. M. F. M. F. January 61 67 .. .. 61 67 128 February 54 57 .. 1 54 58 112 March 45 50 .. .. 45 50 95 April 57 46 1 1 58 47 105 May 59 56 •• •• 59 56 115 June 42 41 .. 1 42 42 84 July 42 33 1 .. 43 33 76 August 60 52 .. .. 60 52 112 September 37 39 2 .. 39 39 78 October ,. 48 40 1 .. 49 40 89 November 41 36 .. .. 41 36 77 December 48 56 .. .. 48 56 104 Totals 594 573 5 3 599 576 1175 35 Table XII. Registered Marriages for each Quarter during the Years 1893, 1894, 1895, 1896, 1897, 1898, 1899, and 1900, in the Parish of Woolwich. District. Year. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Totals. DOCKYARD AND ARSENAL SUBDISTRICTS. 1893 110 136 193 175 614 1894 120 136 151 178 585 1895 112 137 142 188 579 1896 118 133 146 205 602 1897 122 156 134 155 567 1898 107 149 150 169 575 1899 99 135 144 134 512 1900 140 132 162 155 589 Table XIV. Return of Persons admitted into the Temporary Shelter (162, Samuel Street) during the Years 1895, 1896, 1897, 1898, 1899, and 1900. Nature of Disease. 1895. 1896. 1897. 1898. 1899. 1900. Families Persons Families Persons Families Persons Families Persons Families Persons Families Persons Small Pox .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 8 26 7 20 10 40 17 51 5 22 2 7 Diphtheria 4 11 4 10 13 40 7 24 6 17 3 8 Typhoid or Enteric Fever 2 8 2 10 2 8 3 6 •• •• •• •• Totals 14 45 13 40 25 88 27 81 11 39 5 15 Two of these cases were admitted to the new shelter in Sun Street. 36 Table XV. Return of the number of Houses Inspected, Notices Served, etc., by the Sanitary Inspectors during the year 1900. Names of Inspectors. Number of Houses. Intimation Notices. Statutory Notices. Inspected. Re-inspected. Number Served. Number complied with. Number Served. A. Mackie 2123 1405 565 391 117 W. Woolley 2021 1031 487 246 110 Totals 4144 2436 1052 637 227 38 Table XVI. List of Common Lodging Houses in Woolwich under the License of the London County Council. No. Situation of House. Number of Beds Authorised. Single Men. Single Women. Married Couples. 1 3, High Street 22 .. .. 2 5 „ 44 .. .. 3 49 „ 26 .. .. 4 50 „ 24 .. .. 5 51 „ .. 6 8 6 52 „ 18 3 3 7 53 „ 16 .. 5 8 56 „ .. 1 7 9 56 „ 18 .. .. 10 63 „ .. 1 7 11 64 „ 20 .. .. 12 76 „ 4 5 4 13 77 „ 3 2 6 14 81 „ .. 8 1 15 82 „ 7 6 3 16 93 „ 30 .. .. 17 102 „ 37 .. .. 18 6, Nile Street 5 .. 3 19 7 „ 13 .. .. 20 60, Beresford Street 35 .. 13 21 10, Market Hill 10 .. .. 22 4, Warren Lane 30 .. .. 23 12 „ 29 .. .. 24 13 „ 11 .. .. 25 1, Ropeyard Rails 16 .. .. 26 2 „ 21 .. .. 27 4 „ 22 .. .. 28 7 „ 18 .. .. 29 9 „ 37 .. .. 30 10 „ 32 7 11 31 11 „ 24 .. 3 32 21 „ 11 .. 4 33 21a .. 12 5 34 32 „ 20 .. .. 35 43 „ 16 .. .. 36 10a 26 .. 3 37 34, Albert Road, N.W. 19 .. .. 39 Table XVII. List of Slaughterhouses, Cowshed, Licensed by the London Council in the District of Woolwich during the year 1900. No. Situation of Slaughterhouse. No. Situation of Slaughterhouse. 1 At rear of 93, New Road 4 At rear of 30, Hare Street 2 Love Lane, rear of Wellington Street 5 At rear of 12, Church Street 3 At rear of 25, Hare Street 6 At rear of 41, Church Street COWSHED. 1 At rear of 16, Pellipar Road 40 Table XVIII. List of Bakehouses in the Parish of Woolwich during the year 1900. No. Situation. No. Situation. 1 153, Powis Street 19 37, Prances Street 2 16 „ 20 32, Church Street 3 42 „ 21 48 „ 4 98, High Street 22 23, George Street 5 100 „ 23 21, Albion Road 6 111 „ 24 51 „ 7 140 „ 25 60, Sand Street 8 31, Beresford Street 26 33, Samuel Street 9 16, The Common 27 8, Hill Street 10 53, Wellington Street 28 72, Henry Street 11 94 „ 29 24, Chapel Street 12 88, Artillery Place 30 36 „ 13 10, King Street 31 45, Warwick Street 14 15, New Road 32 29, Charles Street 15 57 „ 33 Dock Street, North Woolwich 16 3, Green's End 34 109, Albert Road „ 17 90, Brookhill Road 35 32, Beresford Street 18 82 „ 41 Table XIX. List of Houses Registered under the late Woolwich Local Board of Health's Bye-Laws, made the 13th August, 1895, with respect to Houses Let in Lodgings, or occupied by Members of more than one Family. Registered No. Situation of House. 1 44, Ropeyard Rails 2 8 „ 3 14, Frances Street 4 10, Spray Street 5 10£ 6 15, Nelson Street 7 16 ,, 8 17 9 62, Beresford Street 10 62a „ 11 6, Ropeyard Rails 12 12, Collingwood Street 13 55, High Street 14 13, Frances Street 15 22, Ropeyard Rails 16 23 „ 17 24 „ 18 26 „ 19 27 „ 20 28 „ 21 23, Union Buildings 22 1, Mary Ann Cottages, Back Lane, Frances Street 23 2 „ 24 3 „ 25 2, Samuel Street 26 4 „ 27 5, Chapel Street 28 6, Ann Street, Rush Grove 29 6a ,, 30 7 „ 31 8 „ 32 10 „ 33 11 „ Registered No. Situation of House. 34 12, Arm Street, Rush Grove 35 1, Catherine Square 36 2 „ 37 3 „ 38 4 „ 39 5 „ 40 10, Mulgrave Place 41 12 „ 42 6, High Street 43 23, Frances Street 44 3, Warren Street 45 6 „ 46 4 „ 47 8 „ 48 9 „ 49 15, Frances Street 50 16 „ 51 18 „ 52 24 „ 53 21 „ 54 7, Warren Street 55 13, Collingwood Street 56 2½ Market Hill 57 171, Powis Street 58 177 „ 59 25, Frances Street 60 1, Sow Alley 61 2 „ 62 1, New Street 63 2 „ 64 5 „ 65 6 „ 66 2, Ordnance Terrace, Shooters' Hill Road 43 ANNUAL REPORT on the HEALTH OP PLUMSTEAD, foe 1900. To the Mayor, Alderman ancl Councillors of the Metropolitan Borough of Woolwich. Your Woeship and Gentlemen, I have the honour to present to you my report on the health of Plumstead Parish during the past year. A.—-Vital Statistics. 1. Population.—I have estimated the population on the basis of the number of occupied houses, as I did last year, assuming that the number of persons to a house remains the same as at the Census of 1896, viz : 6.14. The number of occupied houses on June 30th, was 11,091, which gives a population of 68,098, and all rates given in this report are calculated on this population unless otherwise stated. The estimated increase of population is 2843. 2. There were in June 1900, 3,440 houses in the West Rate Collector's district, and 7,651 in the East district, shewing increases of 126 and 337 respectively during the year. 3. Births.—The birth rate was 29.3 compared with 30.2 in 1899; this is the lowest rate yet recorded in Plumstead, though the number of births is the highest on record. The natural increase of the population was 936, and the estimated increase 2843, which infers an immigration from other districts of 1907 persons. 44 There were 421 births in West and 1573 in East Plumstead. 4. Deaths.—The death rate was 15'5 compared with 140 and 162 in the two preceding years. This rate and all other rates given in the report are, unless otherwise mentioned, corrected for deaths in Public Institutions, i.e., deaths of non-parishioners occurring in institutions in the Parish are excluded, and deaths of parishioners in outlying institutions are included. There were 265 deaths in West and 793 in East Plumstead. The highest number of deaths occurred in the first quarter, January to March, and the lowest number in the fourth quarter. 5. Meteorology.—The weather was, on the whole, mild in the winter months, but the temperature of the summer months was above the average. As regards the effect of weather on mortality it was an average year. 6. Infant Mortality.—The number of deaths under one year per 1,000 births was 129, compared with 156 and 124 in the two preceding years. Of the 261 deaths under one year 69 occurred in the first quarter, 48 in the second, 93 in the third, and 49 in the fourth. 7. The infant mortality was 99 in West Plumstead, and 138 in East. The following table gives the deaths under one year per 1,000 births in the two districts during recent years:— Table A. West. East. 1893 132 143 1894 77 100 1895 96 146 1896 98 145 1897 106 119 1898 174 150 1899 100 131 1900 99 138 45 8. Of the 261 deaths under 1 year 54 were from debility at birth, wasting, congenital defects and dentition, 28 from premature birth, and 50 from diarrhœa and inflammation of the bowels. 9. There were 402 deaths under 5 years, being 38 per cent, of the total deaths, and 5-9 per 1,000 population. 10. The Zymotic death-rate (i.e., the rate from Small Pox, Scarlet Fever, Diphtheria, Enteric Fever, Measles, Whooping Cough, and Diarrhoea) was 2.1, compared with 1.3 in 1899, and 3.5 in 1898. 11. Uncertified deaths.—There were 29 uncertified deaths, being 2.7 per cent, of totaldeaths, compared with 2.9, 1.3, 4.1, and 3.4 in the four preceding years. Although this shews an improvement on the two past years, it is still far above the average for London and other large towns. Eleven of the uncertified deaths were of children under 5 years of age: they included five infants under one month, whose deaths were attributed by the Registrar to convulsions from congenital debility. Such eases as these are frequently the result of improper feeding, of neglect, or of syphilis, and it would seem very desirable that an enquiry should be made into each by a competent medical man, whether an inquest is held or not. 12. In continuance of the action described in my last report on the subject of uncertified deaths and death registration, the Health Committee of the late Vestry petitioned the Local Government Board in favour of early legislation on the lines of the Eeport of the Select Committee of Parliament published a few years ago : all the London local authorities were requested to take the same action. A Special Eeport on this matter is appended to this Eeport. I regret that His Majesty's Government have yet made no mention of any proposed legislation in this connection, 46 13. There were 50 inquests compared with 39, 35, 38 and 38, in the four preceding years. Fifteen were on persons under five years, and 35 on persons over five. Pour infants under three months were accidently suffocated in bed with their parents. There were four suicides, one from shooting, one from hanging, and one from cut throat, all men ; and a woman by attempted abortion. A man of 54 and a woman of 46 died from falls, the former being intoxicated. A woman of 68 and a child of 19 months died from burns. A woman of 47 died of hemorrhage from an ulcerated varicose vein. Two persons were run over, one by a truck and one by a bicycle. Four men were killed by machinery or otherwise injured while at work. There were two deaths from lead poisoning. One man was found drowned. The remainder were deaths from natural causes. Table B. 14. East and West Plumstead compared. West. East. Population—Census 1891 15867 36566 1896 16714 42538 ,, estimated to middle of 1900 17820 50278 Births 421 1573 Deaths 265 793 Birth Rate 23.6 31.2 Death Rate 14.8 15.7 Deaths under 1 year 42 217 ,, ,, ,, per 1000 births 99 138 Death Bate from Phthisis 1.17 1.59 47 (N.B.—The population of these two districts is estimated on the supposition that the total increase of the population of Plumstead between 1896 and 1900 is distributed between West and East in the proportion of 1 to 7 as was the increase between 1891 and 1896). 15. The above table shews that the birth-rate has decreased more markedly in the West than in East Plumstead. The general and infantile death-rates in West Plumstead were nearly identical with the rates of 1899, the increase being confined to East Plumstead. Apparently the incidence of Diphtheria and Measles fell chiefly on East Plumstead. 16. Plumstead compared with other Sanitary Districts.—Five Metropolitan districts had a lower death-rate, namely, Lee, Wandsworth, Stoke Newington, Hampstead and St. George's Hanover Square. Six Metropolitan districts had a lower infantile death-rate, namely, St. Olave's, St. Giles, Stoke Newington, Hampstead, Mary-le-bone, and St. George's. Plumstead stood higher than all the rest (see Table VIII.), The birth-rate was a little above the average for London, namely, 28.6. The deaths from measles and diphtheria were a little above the average for London, and those from scarlet fever, enteric fever, diarrhoea, and phthisis, below. Small Pox. 17. There were no cases of small-pox, nor have been since 1896. There were 1,632 primary vaccinations compared with 1610 in 1899. If we compare this number with the number of births in 1899, and deduct the number of children who died under one year of age, we see that less than 100 children are unaccounted for, 48 Scarlet Fever. 18. There were 300 cases of scarlet fever compared with 707 in 1899. This is the lowest number of cases of scarlet fever in the last nine years. There were only 5 deaths. The case-rate and death-rate per 1,000 population were 4.4 and 0.04 respectively. (See Table V., which gives these rates for the past ten years.) Both these rates are lower than in any year since 1891. 19. Of the 300 cases 246 were removed to the Fever Hospital, or over four-fifths of the whole, showing that the proportion of cases treated at Hospital has continued to increase. In four cases the diagnosis was not confirmed by the Hospital Medical Officers. Table D. 20. Mortality per cent, of cases :— Treated at Home. Treated at Hospital. 1893 4.0 8.0 1894 3.3 4.8 1895 3.0 3.0 1896 4.3 3.7 1897 0.7 2.1 1898 3.1 2.7 1899 1.1 0.7 1900 3.7 1.2 The above table seems to shew that whereas in former years when a much smaller proportion of cases went to Hospital the cases that did go were the more serious ones, in recent years the cases left at home are largely the most fatal. 21. Two-thirds of the cases were between the ages of 1 and 10. Earl Street, Conway Road, and Ancona Road Schools had the largest number of pupils affected, but all the schools with the exception of Knee Hill, had a considerable number of cases. With the exception of Knee Hill (where no cases occurred) Bloomfield Road was the least affected. 49 22. Of the houses in which cases occurred there were 203 with only one case, 30 with 2, and 11 with more than 2. 23. In my last report I mentioned three additional measures which were desirable for controlling the spread of Scarlet Fever; they were:— (1.) The thorough inspection of country cowsheds, and the registration of the source of supply of every milk vendor. (2.) The periodic inspection of school children. (3.) Some modification in the direction of diminished stringency of the Arsenal regulations re infectious diseases. The first two measures are beyond the control of the local authority, but the third has been carried out by arranging with the Principal Medical Officer of the Arsenal that employees in houses where infectious disease exists, shall not be prevented from pursuing their work, if I certify that the patient is efficiently isolated. I have so far been only thrice asked for this certificate. I believe this relaxation of the Arsenal regulations will lead to fewer cases of concealment, and consequently diminish the spread of infection. 23a. The highest number of cases occurred in January (50), in March (40), and in October (32); and the lowest in August and December (13). 24. Return Cases.—There were nine cases in which the Scarlet Fever began within not more than ten days of the return from Hospital of another member of the family convalescent from the same disease. One case began 3 days after such return, two 4 days after, three 6 days, two 9 days, and one 10 days after. Five of the returned patients had a running from the nose, and one a discharge from the ear, when they arrived home. The average stay of the returned patients in hospital was twelve and a-half P 50 weeks, two having been detained over 16 weeks, a fact which indicates that the increase of duration of stay in hospital cannot be looked to as a means of avoiding return cases. 25. Dr. Simpson's Report on return cases, dated 5th June, 1899, has at last been published by the Asylums Board. Dr. Simpson finds that 1.6 per cent. of cases discharged from Hospital are the means of infecting other members of the family on their return home, and that the majority of them are infective through discharge from mucous membranes such as the mouth, throat, nose, and ear. He makes the following recommendations for obviating the occurrence of such cases:— (1). That warm baths should not be given immediately before the convalescent is sent out of Hospital, especially in winter. (2). That the cases are not due to premature discharge, but that duration of stay in Hospital should be diminished. (3). That local and antiseptic treatment should be applied for discharges from mucous membranes, and that patients should be moved to less infective wards before discharge. (4). That the Medical Officer of Health should be notified as to discharge of the patient from Hospital, or printed instructions should be given to the parent or guardian as to suitable precautions. (5). That Sanitary Authorities should pay attention to steam disinfection of clothes, toys, such as dolls, &c., as well as to bedding. The report having been referred to the College of Physicians they recommend further investigation, and meanwhile it appears no action will be taken. The recommendations (2), (3) and (4) fully bear out the opinion I have frequently expressed, and as regards (3) and (4) I fail to see why they should not be at once carried out as far as possible. 51 Diphtheria. 26. The following table gives the eases, deaths, and rate per 1,000 population during the year and preceding nine years:— Table E. No. of Cases. Case-Rate. No. of Deaths. Death-Rate. 1891 37 0.7 6 0.11 1892 118 2.0 38 0.70 1893 179 3.2 65 1.17 1894 118 2.0 34 0.59 1895 148 2.5 34 0.58 1896 198 3.3 60 1.00 1897 131 2.2 24 0.39 1898 110 1.7 15 0.24 1899 182 2.8 16 0.24 1900 240 3.52 24 0.33 It thus appears that the number of cases and case rate in 1900 were the highest in the past ten years. The death-rate from Diphtheria, however, has only been three times lower in that period. 27. The case death-rate was 100 per cent which with the exception of 1899, when it was only 8.8, is the lowest it has been since notification began. 28. Two hundred and seventeen cases were treated at Hospital, or nine-tenths of the whole, the highest proportion of hospital treated cases I have yet reported. The case death-rate was 17.5 at home and 9.2 at Hospital. Two of the four deaths which occurred at home were not treated with antitoxin, the medical attendant not believing in this "newfangled" treatment. D 2 52 29. In January 30 cases occurred. February 15 „ „ March 32 „ „ April 23 „ „ May 30 „ „ June 21 „ „ July 11 „ „ August 18 „ „ September 14 „ „ October 20 „ „ November 17 „ „ December 10 „ „ This monthly occurrence of cases agrees with that of Scarlet Fever in the fact that the highest number of cases occurred in January and the lowest in December. 30. The highest number of cases occurred among children attending Knee Hill School, where 31 children, or 20 per cent, of the pupils on the roll were affected. Burrage Grove School was the next most affected, but only had 1.8 per cent. of the number on the roll attacked. Ancona Boad, Bloomfield Boad, and Conway Boad come next in order, the other Schools being much less affected. In 1899, Ancona Boad and Burrage Grove Schools were the most affected. 31. Of the 240 cases, 45, or nearly one-fifth occurred in the small isolated district known as Abbey Wood. This district being low-lying might be considered a likely one for the occurrence of Diphtheria, but as a fact no case occurred there in 1899 and very few cases have occurred in previous years. Further, only one case as far as I could learn occurred last year in the adjoining and similarly situated part of Abbey Wood which is in Belvedere, and all the cases, with two exceptions, were either 53 themselves attendants at Knee Hill School, or other children in the house attended this School. It is obvious then, that it is to the School, rather than the locality that we must look as the principal source of the disease. 32. Of the 45 cases at Abbey Wood 6 occurred in one house between the 1st and 10th of January, 5 of which must be attributed to personal infection (before medical attendance and isolation) in a dirty and overcrowded house. There were no cases after this till the 9th March, but from that date till the 18th June cases were notified every few days. After that day only one case occurred. On April 4th I reported to the Vestry that 10 cases had occurred in connection with Knee Hill School "that there has only been one case of Diphtheria recently in the Erith side of Abbey Wood. The evidence points plainly to the Knee Hill School being the probable source of the prevalent Diphtheria at Abbey Wood. I have written to Professor Smith on the subject. I think this is just a case where all the children attending the school should be examined for latent Diphtheria. The drains have been tested by the School Board and found satisfactory." Unfortunately, by the School Board's direct prohibition, I am not allowed to examine children in their schools myself. 33. In consequence of a further report, dated 16th May, on the continued prevalence of Diphtheria at Abbey Wood, in which I stated that as I could not examine the children and exclude suspected ones the only way would be to close the whole school, the Yestry directed a letter to be sent to the School Board asking them to allow me to examine the children. The Board did not grant this request, but apparently as a result of it one of the Board's Medical Officers came down on the 54 23rd and 25th May and examined the children, and certain ones were excluded. After these steps, delayed unfortunately so long, eight cases occurred, but all were secondary cases with one exception, i.e. only one home was invaded which had not already been affected. I learnt afterwards that two of the children excluded were found to have the Diphtheria Bacillus in their throat. I visited the home of one of these, and warned the mother as to keeping her children away from school, and as to disinfection of the mouth and throat; but the other child had been moved from the locality before I heard of the exclusion. 34. One of the cases at Abbey Wood occurred in a gipsy's tent. A magisterial order was obtained for removal to hospital, but was disobeyed. A summons was issued, and a fine of 20s. and 2s. costs inflicted, but I failed to obtain removal to Hospital. 35. Bacteriological Diagnosis.—The throat secretions of 19 doubtful cases were examined by the Jenner Institute. Eight were found to be cases of Diphtheria. In one the pseudo diphtheria bacillus was found. In 1899 15 cases were bacteriologically examined, and two were found to be Diphtheria. It is to be regretted that more doctors do not avail themselves of this mode of diagnosis, the use of which would often enable the proper treatment to be applied earlier, and prevent the risk to the patient and loss of credit to the doctor which is incurred by sending a non-infectious patient to the Fever Hospital. The diagnosis of Diphtheria in five of the cases sent to hospital was considered erroneous by the Asylums Board's Medical Officers. This is a very small proportion compared with other districts of London. It is curious to find that two of the supposed erroneous diagnoses were cases in which the Jenner Institute had found the diphtheria bacillus present. 55 36. There is no reason to connect the occurrence of cases of Diphtheria with special streets or localities. Of the three streets which had most cases in 1899, namely, Robert Street, Sandy Hill Road, and Heavitree Road, the first two had last year one each, and the third none. Enteric Fever. 37. There were 39 cases of Enteric Fever, compared with 25 in the previous year. The rate per 1,000 population was 0.57, which is the highest rate since 1890, with the exception of 1895, when it was 3.67 (see Table V.) There were 9 deaths, giving a death-rate of 0.13; this rate was exceeded in 1895, and also in 1893, but otherwise is higher than any year since 1890. 38. Enteric Fever was more than usually prevalent in London, where the case-rate was 0.94, and the death-rate 0.15, both rates being higher than those in Plumstead. 39. The 39 cases occurred in 36 houses situated in 35 streets, these streets being distributed all over the Parish. Seven cases occurred in the Reidhaven Road district, three being in one house. In this case a child was apparently the source of infection of her father and mother. A list of the houses is given in Table XIII. 40. One case was a nurse who had been nursing an Enteric case at West Ham Infirmary. Another was nursing her sister for the same disease. Eleven cases had, within a few weeks of the illness, eaten shell fish, viz., two oysters, four mussels, one periwinkles, and two whelks. Some of these were in the habit of frequently partaking of molluscs, but others had taken some just about two or three weeks before illness commenced i.e., at the usual interval 56 between infection and commencement of illness. Five had taken celery shortly before the illness, one was a greengrocer's boy and one was a gardener who visited Stratford Market daily. Three of the remaining patients were people of markedly dirty habits. 41. In five cases some defects were found in the drainage by means of the smoke machine, which was used at all the houses implicated; 8 houses were found dirty. 42. To summarize there were 35 primary cases of which 18 may probably have been due to celery or shell fish or other food imperfectly cooked. There was no reason to suspect the milk supply, and the distribution of the houses negatives the idea that drainage was in any way a common cause of the disease. 43. I am thus unable to give a satisfactory explanation of the increase of enteric fever; but it appears that an unusually large proportion of the cases are attributable to imperfectly cooked food, which like shell fish and celery are known to be very liable to convey the Infection. It is possible that the return of soldiers convalescent with enteric, from South Africa to country and seaside places, may account for increased infectiousness of these articles of diet. 44. A specimen of blood was examined bacteriologically for Widal's reaction by the Jenner Institute in 19 cases, and a positive result obtained in 12, i.e., 12 out of 19 doubtful cases were found to be enteric. In 1899 four cases were examined with three positive results. Erysipelas. 45. There were 73 cases of Erysipelas, compared with 54 and 64 in the two preceding years. From Table V. it appears 57 that there has been a progressive increase in the notifications of Erysipelas per 1,000 population since 1896, but the death-rate from this disease has diminished; there was only one death, giving a death-rate of 0.01, the lowest since 1890. This curious behaviour of the infection does not stand alone, for Scarlet Fever has varied in an almost exactly parallel way during the five years ending with 1900, i.e., there was a progressive increase of the case-rate, and an almost progressive decrease of the death-rate. Evidently both these diseases are influenced by some similar unknown conditions. Puerperal Fever. 46. There were 4 cases of Puerperal Fever, with 2 deaths, compared with 5 cases and 2 deaths in 1899. One of the cases, a fatal one, was attended by a midwife. Measles. 47. There were 46 deaths from Measles, compared with 3, 59 and 3 in the three preceding years. The death-rate was 0.67. The average death-rate of 1899 and 1900 was lower than that of any two successive preceding years since 1885 with one exception. The death-rate in London from Measles was 0.42 48. I received 581 notifications of children kept from School by School Teachers, namely:— Vicarage Road 33 Central 12 Earl Street 85 Plum Lane 68 Burrage Grove 41 Slade 15 Knee Hill 3 Purrett Road 102 Bloomfield Road 51 Plumstead Road 4 Conway Road 68 Ancona Road 11 High Street 69 Eglinton Road 14 58 No notifications were received from All Saints' School. In 1899 52 notifications were received, and in 1898, 609. 49. On my recommendation the following classes of Infant Departments were closed on account of the prevalence of measles:— Class. School. Date. Period of Closure. A Earl Street Feb. 28. 3 weeks. 3 Central Schools May 4 „ 4 „ June 4 „ G & A Bloomfield Boad „ 4 „ H & C High Street „ 4 „ C & D Bloomfield Boad „ 3 „ Infant Dept. Conway Boad June 3 „ „ Purrett Boad July 10 3 „ A & G Eglinton Boad Oct. 3 „ and later, on Professor Smith's advice the whole Infant Department of High Street School was closed. The affected class rooms were fumigated with sulphur, and the managers of Sunday Schools were asked to exclude children attending the closed classes, or coming from the same house. 50. The result of the closure of the above classes was in all cases satisfactory, in causing the prevalence of Measles in the School affected to cease. To this closure may, I think, be ascribed the lowness of what may be called the biennial high wave of Measles last year. During the past four years—the time during which I have been in a position to advise, and have advised, the closure of classes, 48 lives have been saved compared with the preceding four years and not allowing for increase of population. 51. A letter was received from the School Board, enclosing a report from their Medical Officer, criticising my action in closing a certain class for a period of two weeks. 59 A reply was sent by your Vestry, justifying my action, and shewing that the report of the School Board's Medical Officer was based on imperfect information. 52. Several years ago, I reported that it was desirable that some or all of the Sections of the Public Health (London) Act, 1891, relating to prevention of infectious diseases should be made applicable to Measles, and pointed out that this could be done without Measles being made a notifiable disease. The matter has now been taken up by the County Council, and a letter was received from the Council asking whether this proposal met with the Borough Council's approval. On my report, a reply was sent in the affirmative. I also reported in favour of making notification of Measles compulsory on the householder, but not on the medical attendant. Whooping Cough. 53. There were 27 deaths from Whooping Cough, 8 being in West Plumstead, and 19 in East. The death-rate was 0.39, compared with 0.15 in the preceding year. Phthisis. 54. There were 101 deaths from tuberculosis of the lungs, 24 of which occurred in the Infirmary or other public institutions. The following table gives the death-rate from Phthisis during the past twelve years:— 1889 1.42 1890 1.87 1891 2.16 1892 1.85 1893 2.0 1894 1.23 60 1895 1.64 1896 1.3 1897 1.5 1898 1.27 1899 1.45 1900 1.48 Although the rate last year was higher than in the two preceding years it has been exceeded six times in the twelve years. In London the rate was 1.70. 55. Comparing the four consecutive periods of three years each, 1898-1900 has the lowest death-rate of any; so that there is reason to think that the efforts made in recent years to prevent the conveyance of tubercular infection have been to some extent successful. 56. The rate in West Plumstead was 1.17, and in East 1.59. 57. Cases occurred in 80 streets: 7 each in Ann Street and Villas Road, 6 in Maxey Road, 4 each in Glyndon Road, Burrage Road, Barth Road, and Kashgar Road, 3 each in Sandy Hill Road, Reidhaven Road, High Street, and Vicarage Park, and 2 each in Lakedale Road, Palmerston Road, Bramblebury Road, Sladedale Road, Abbey Wood, Eton Street, Glenside Road, Crescent Road, Hargor Road, Bassant Road, Macoma Road, Princes Road, Station Road, and Inverary Place, and 1 each in 55 other roads. Ann Street has had at least 3 cases in each of the last three years, and Maxey Road at least 2 cases. More than one case occurred in 1899 in each of the following : Reidhaven Road, Bramblebury Road, Station Road, and Sladedale Road. 61 58. Out of 119 cases visited, disinfection was agreed to and performed in 18. Out of 90 cases in which particulars were obtained, 58 were males and 27 were Arsenal employees. In 1899 disinfection was performed in 11 cases. 59. Besides the 101 cases who died I received notification of 31 cases from the Poor Law Medical Officers. 60. Notices were printed and distributed at Public Houses, workshops, &c., warning persons against spitting on the floor. But in the matter of systematically dealing with phthisis as with other infectious diseases, as regards notification, bacteriological diagnosis, thorough cleansing of infected rooms, &c., Plumstead and indeed the Metropolis, is far behind several provincial towns, notably Manchester and Brighton. Diarrhœa. 61. There were 36 cases of diarrhoea and 25 of enteritis, which is the same thing practically under a different name, and which in previous reports I have included with diarrhoea. This is fewer than in the three previous summers but is yet above the average. The nomenclature of this disease has been in an unsatisfactory condition, so that it has been impossible to compare its prevalence in different towns. But last year as a result of the action of the Society of Medical Officers of Health, the Royal College of Physicians decided that medical men should be asked to discontinue the use of the terms diarrhoea and gastro enteritis, &c., and to use the name epidemic or zymotic enteritis. A copy of this recommendation has been sent round to all the medical practitioners in Plumstead. No cases were registered last year under this title. 62 62. Of the 61 cases, 50 were under 1 year of age, and 8 between 1 and 5 years: 16 cases occurred in West, and 45 in East Plumstead. 63. The death-rate for Diarrhoea, excluding Enteritis, and Gastro-Enteritis, as is done by the Registrar-General, was 0.53, compared with 0.78 in 1899, and 0.77 in London. 64. I noticed that the side streets in Plumstead were not effectually watered, and reported that this was very desirable, as dust getting into food is an important cause of Diarrhoea. A recommendation was made to the Works Committee that additional plant should be procured to enable all the streets to be properly watered. 65. The diffusion of instructions to mothers as to the feeding and care of young infants, is perhaps the most important means of preventing Diarrhœa. For this, lady health visitors, or sanitary inspectors are requisite. I have continued to distribute the instructions which I prepared, and were printed by the Vestry, as far as opportunity has occurred. Alcoholism. 66. There were 16 deaths from Alcoholism and cirrhosis of the liver, 3 in West Plumstead and 13 in East. Probably half the deaths from Phthisis and diseases of the kidney and a large proportion of those from heart disease, pneumonia, and other diseases were also mainly the result of intemperance. Rheumatism. 67. There were 8 deaths from Rheumatism compared with 4, 1, 2, & 7 in the four preceding years. 29 cases of Rheumatism were nursed by the District Nursing Association compared with 27 in 1899. All the deaths were in East Plumstead. Of the cases nursed, Ann Street, Walmer Road, Plumstead Common Road, and Princes Road, had 2 cases each. 63 Pneumonia. 68. There were 39 deaths from lobar pneumonia and 44 from lobular pneumonia. 83 eases of pneumonia were nursed by the Nursing Association. B. Administration. 69. Water Supply.—The water supplied by the Kent Water Company continues to maintain its high quality. The supply on Shooter's Hill above Cantwell and Nithdale Boads is still I regret to say intermittent. 70. Storage Cisterns are put in all new houses. The Sanitary Inspectors, when inspecting for the purpose of giving certificates of having a proper and sufficient water supply, always examine the cistern to see that it is easily accessible for cleansing and properly covered. In 14 cases cisterns were found inaccessible or uncovered. 71. Sewers.—The sewers have worked satisfactorily, and no nuisance has come to my knowledge from obstruction or overflowing of sewers. There were however a large number of complaints of offensive smells from open manholes in the public roads. 72. . Cemetery.—I inspected the Cemetery and found it, on the whole, well maintained. I recommended some improvements in the w.c. accommodation, and the planting of further rapidly-growing bushes; orders were made for this work to be done. There were 1,007 interments compared with 812 in 1899. 73. Churchyard.—There were 164 interments in the Churchyard compared with 253, 177,193 and 146 in the four preceding years. There is, on the whole, a diminution in the number buried in this overcrowded yard, but a slower one than is desirable. 64 I inspected this burying ground on more than one occasion; it is maintained as before. 74. Mortuary.—I visited the Mortuary at different times and saw that it was kept clean. It was used on 78 occasions compared with 31, 33, and 49 in the three preceding years. Sixtyseven bodies were there for inquests. Only one was a case of infectious disease. 75. Health Refuge.—The Refuge was used once in January for a mother and two children. This is the first time it has been used since its construction. 76. Bakehouses.—I inspected all the bakehouses in April and October and found them up to the usual standard. 77. Cowhouses.—I inspected all the Cowhouses in company with Chief Inspector Duck, and found the improvement noted last year continuing. Only one was reported as unsatisfactory from closure of the means of ventilation: several cows in this shed were observed to be coughing, as is commonly the case when the sheds are kept close, whereas, in well-ventilated sheds, I seldom notice this sypmtom. 78. In 1899, Mr. Simpson, M.R.C.V.S., and two assistants, examined all the cows in licensed premises in London, on behalf of the County Council, for the detection of Tubercular disease of the udder; 5,144 cows were inspected, and 4,484 were found to be free from disease or abnormalities of the udder. Of the 680 cows not found healthy, 214 had atrophy of one or more quarters, 165 had chronic indurations of the udder, 82 acute mastitis, and 12 only had symptoms of tubercular disease of the udder. As a result of his report, the Council 65 decided to have the examination repeated at intervals of three months, and to send two samples of milk from various parts of London to Dr. Klein for bacteriological examination. 79. Dust Shoots.—The house refuse has continued to be deposited on the levels, and has now reached to within a short distance of Church Manorway. It is to be hoped that the erection of the dust destructor will not be long delayed. 80. The Public Health Committee had under their consideration a dust-shoot in Wickham Lane used for trade purposes concerning which I reported that it did transgress the County Council Bye-Laws as to proximity to occupied houses. The Committee having viewed the deposit on two occasions finally decided there was no ground for taking any summary measures, the owner promising to burn, as far as possible, the organic matter as deposited, and to keep the rest of the deposit covered with a layer of inoffensive material. 81. Dust Collection.—The dust collection under the new contractors has not given rise to much complaint, there having been only 85 complaints of non-removal in the nine months April to December, compared with 711 in the preceding 15 months The carts, too, have been better covered. But nuisances continue to occur of overloaded carts dropping refuse behind them, of refuse falling in the road in the process of loading, and offensive dust being blown about at the same time. The collection cannot be satisfactory until it is made with suitably constructed carts. Owing to the large use of gas-stoves there is on the whole a smaller proportion of ashes and cinders in the house refuse, and a larger proportion of organic offensive refuse. 82. Drams at the Workhouse.—In my last report I stated that "a foul smell having been observed in the Receiving Ward of the Workhouse the Chief Inspector examined the drains and e 66 found that this ward had been built over a drain which was very defective, and on which there was a defective manhole where a stoppage had occurred, converting the manhole into a cesspool. When the whole course and branches of this drain were examined by openings in 15 places the joints of 48 out of 50 pipes were found defective." The Guardians, after considerable delay, came to the conclusion to relay that part under the receiving ward only, and to dispute their liability to relay the whole. The Vestry refusing to yield from their demands, the guardians were finally proceeded against at the Police Court on May 30th, and after two adjournments were fined £100 and £5 5s. costs for noncompliance with the notice. The second adjournment was to enable the guardians to appeal to the County Council, a privilege they had previously neglected. The County Council having considered the merits of the case gave their decision against the Guardians, and it was only left to the magistrate to fix the penalty. Finally the whole work was satisfactorily done. This matter occupied a very large part of the Inspector's time. 83. Houses unfit for occupation.—I only reported one house as unfit for occupation, namely 234, High Street. This was an old house in a very damp, dirty and dilapidated condition. It was closed by the owners on receipt of notice under the Housing of the Working Classes Act, Part II. 84. Smoke Nuisance.—The Laundry in Chesnut Road was complained of as causing smoke nuisance repeatedly by certain residents in the neighbourhood. After a very large number of observations had been taken by the Sanitary Inspector, it was finally decided to take proceedings before the magistrate for the abatement of the nuisance, but before this was done the use of the vertical boiler causing the nuisance was discontinued and a new system adopted, and there have been no further complaints. 67 85. Drains.—The Chief Inspector dealt with 43 combined drains which required to be relaid. After investigation and reporting on them it was found that plans existed in 25 cases, in which the work of relaying was executed by the owners; in the remainder the work was done by the Surveyor. In addition to these, 499 choked and defective drains were found, and remedied after notice had been served. In 1899, 777 choked and defective drains were dealt with and 66 combined drains. In three cases the defective drains had been laid within the last three or four years, but before the re-organisation of the Surveyor's department. 86. Offensive Accumulations.—A deposit of offensive matter, rags and paper screened from the sewage at the Outfall Works was found adjoining the Knee Hill Board School, at the time of the prevalence of Diphtheria at that school. It was at once removed on notice being sent to the owner of the field, who undertook to prevent its recurrence. A letter was sent to the County Council calling their attention to the matter. It would appear to be the duty of the County Council to destroy such matter at the Outfall, rather than run the risk of its becoming a danger to health through being removed by a contractor. A similar deposit was found in Harrow Manorway and similarly dealt with. 87. Gypsies.—Repeated visits to gypsy vans and tents were made with a view to enforcing the Bye-laws, especially as regards water supply and w.c. accommodation. The usual result of such visits is that the gypsies move to another camping ground, but in one case near the football ground, two earth closets were erected in pursuance of notice. 88. Neglect to bury.—Two cases of bodies causing a nuisance from want of interment were complained of and dealt with, one being removed to the mortuary, and one being buried by the E 2 68 order of the Vestry, but the expenses paid by an insurance society. 89. Registration of houses let to two or more families.—At the commencement of the year there were 18 houses on the register. I recommended during the year the registration of 14 additional houses. Notices were served on the landlords of most of these houses, but owing either to objections received, improved conditions as to cleanliness and overcrowding, or reduction to occupation by only one tenant, there were finally only four of them registered leaving 22 houses on the Register, December 31st. These houses were all inspected several times during the year, and any breaches of the Bye-laws found were remedied. Two tenants were warned that proceedings would be taken on a recurrence of the offence, but no summonses were actually issued. As to the comparative uselessness of the Bye-laws, as at present drafted, I must refer to what was said in my last report. 90.—Overcrowding.—61 cases of overcrowding were found and remedied by the Sanitary Inspectors. In the three preceding years, 38, 90, and 72 cases were found respectively. It will be seen in my report on the Princes Road district that I found 25 cases of overcrowding among the 153 houses I inspected house to house. Presuming that overcrowding exists in the rest of the parish in the same proportion, and that each case affects only one person, there are over 1,500 persons in Plumstead for whom further sleeping accommodation is required. The standard taken is 300 c.ft. per head for sleeping accommodation, but this standard is a very low one. Out of the 2,705 houses inspected house to house 68, or 2½ per cent., were found in which there were two or more persons to a room. 69 Last year I reported "that the absence of sufficient houses at reasonable rents militates more than anything else against improvement in the sanitary condition of the houses." Applicants for every vacant house being so numerous, the landlord is master of the situation, and the bad landlord has no inducement but the pressure of the sanitary authority, to maintain his property in good condition. The effect of this state of things is that tenants are afraid to complain of any existing nuisance, and the visit of the sanitary inspector is regarded with dread by many, as being a preliminary either to notice to quit, or to a demand to do the repairs themselves, or at least to a rise of rent. Of course I am only referring here to bad landlords. 91. Inspector's Work (See Table IX.)—2705 houses were inspected house to house, compared with 3518 in 1899. In addition 4460 were inspected for infectious diseases and complaints, compared with 3736 in 1899. 312 damp walls were remedied compared with 453 and 510 in the two preceding years. 92. Prosecutions.—2017 intimation notices were sent and 330 were followed by statutory notices; 85 of these not having been attended to were reported to the Vestry Clerk for proceedings, and after the Clerk had written to each of the defaulters, 20 summonses were issued against those who disregarded the Clerk's letter. Particulars of the prosecutions are given in table X. One case was withdrawn by order of the Committee, three cases were adjourned, but all the rest were decided in favour of the Vestry. Apart from the penalty imposed on the Guardians the highest fine was two pounds for letting a new house without having obtained a certificate of a proper water supply, and in two similar cases fines of 20/- each were imposed. In the remaining cases the highest fine was 7/-, and the highest costs allowed 13/-. 70 94. Adulteration under Sale of Food and Drugs Acts.— Out of 200 samples taken by Chief Inspector Duck, 12 or 6 per cent were found adulterated. Proceedings were taken in each instance and a conviction obtained in every case. The highest penalty imposed under the Act was £5 or one month's imprisonment inflicted on George Lambeth of 2, Griffin Eoad, for refusal to serve milk to the Inspector when required to do so; the brother, mother and sister of the defendant were at the same time fined respectively £4, £3, and £2 for obstructing the Inspector on the occasion of the refusal to serve. F. G. Cock, of 13, Eaglan Eoad, was fined £4 for selling milk with 22 per cent of added water and John Rees of 17, Lakedale Eoad, the same amount for selling as butter a mixture of 7 parts of margarine with one of butter. The other penalties varied from 5s. to 40s. and 12s. 6d. costs were allowed in most cases of adulteration. In one case of milk, in which the Vestry Analyst's certificate stated that 10 per cent fat was abstracted, by request of the defendant a sample was sent to Somerset House, with the result that the Government Analyst found that 16 per cent had been abstracted. 95. The adulterations in 1899 were 7 per cent. of the samples, and in 1897-8 3½ per cent. 96. Owing to the widespread existence of peripheral neuritis traced to the presence of arsenic in beer, four specimens of beer from different breweries were obtained and tested for the presence of arsenic with the satisfactory result that none were found contaminated. As the County Council directed a large number of samples to be taken from different parts of London it was not considered necessary to take any more locally. 97. Reidhaven Road District.—The statistics of this district during the past year are less satisfactory than in the preceding 71 year, but a considerable variation must be expected in a small population, and, taken along with the statistics of 1899, I think we may be satisfied that there has been an actual improvement in the sanitary condition of the area. Table F shows that the death-rate and infantile death-rate were each very high, and the birth-rate higher than in 1899. There were, however, fewer deaths from diarrhoea than for five years past. A large part of the increased death-rate was due to the prevalence of measles, whooping cough, and influenza. Table F. Reidhaven Road District. Plumstead. Population 3,733. 68,098. 1894 1895 1896 1897 1898 1899 1900 1894 1895 1896 1897 1898 1899 1900 Total Births .. .. .. 169 143 120 141 1910 1866 1950 1975 1896 1971 1994 Birth Rate .. .. .. 45.2 38.3 32.1 37.7 33.6 32.0 32.7 32.3 30.2 30.2 29.3 Total Deaths 72 84 61 79 74 55 96 736 930 931 835 1016 916 1058 Death Rate 19.8 23.1 16.2 21.1 19.8 14.7 25.7 12.9 15.9 15.6 13.6 16.2 14.0 15.5 Deaths under 1 year 15 42 26 31 25 18 29 180 250 261 230 296 245 261 „ per 1,000 births .. .. .. 183 174 150 205 94 134 133 116 156 124 129 „ 1—5 years 17 18 14 13 14 7 18 127 143 176 99 156 77 402 Diphtheria deaths 1 3 5 2 .. .. .. 40 31 60 24 15 16 24 „ notifications 5 11 15 6 4 5 5 118 148 198 132 110 183 240 Enteric Fever deaths 2 .. .. .. 1 .. .. 6 30 4 3 2 1 9 „ notifications 13 2 3 2 3 4 7 26 214 29 25 28 25 39 Diarrhœa deaths 5 12 8 13 15 8 7 10 48 30 81 105 85 61 Phthisis „ .. .. .. 12 7 5 11 70 96 81 96 88 95 101 72 98. Princes Road and Armstrong Street Areas (see Appendix I.) In the course of the year, I prepared statistics for these areas, and devoted a large amount of time to a house to house inspection of the Princes Eoad area. I referred to the results of this inspection as I went on, but I have not previously had the opportunity of completing my report on it. I now present it in an appendix to this report, with Tables A and B giving the statistics. Table C gives the statistics of the Armstrong Street area, but I was unable to find time to inspect this area house to house as I had hoped to do. This was done however by the Sanitary Inspector, and insanitary conditions and overcrowding remedied in a large number of cases. I am, Gentlemen, Your obedient servant, SIDNEY DAVIES. 73 Table I. Plumstead. For Whole District. Year. Population estimated to Middle of each Year. Births. Deaths under One Year of Age. Deaths at all Age3. Total. Deaths in Public Institutions in the District. Deaths of NonResidents registered in District. Deaths of Residents registered beyond District. Deaths at all Ages. Nett. Number. Rate* Number. Rate per 1000 Births registered. Number. Rate* Number. Rate* 1 2 3 4 5 6 7 8 9 10 11 12 13 1890 50676 1933 37.5 ... 137 ... ... ... ... ... 923 17.9 1891 52754 1867 35.3 245 124 1047 19.8 258 173 43 917 17.4 1892 54060 1932 35.7 225 108 919 16.9 205 133 61 847 15.7 1893 55398 1914 34.5 279 140 1050 18.9 188 140 80 990 17.9 1894 56770 1910 33.6 186 94 776 13.6 167 109 69 736 12.9 1895 58175 1866 32.0 258 134 950 16.3 199 118 98 930 15.9 1896 59615 1950 32.7 271 133 1002 16.8 199 144 73 931 15.6 1897 61090 1975 32.3 240 116 895 14.6 203 129 78 844 13.6 1898 62603 1896 30.2 306 156 1092 17.4 227 149 73 1016 16.2 1899 65255 1971 30.2 251 124 1001 15.3 247 163 78 916 14.0 Averages for years 1890-1899 57639 1921 33.4 251.2 126.6 970.2 16.6 210.3 139.7 72.5 905 15.7 1900 68098 1994 29.3 259 129 1134 16.6 262 167 91 1058 15.5 Corrected by Census 1901 66893 29.8 16.9 15.8 * Bates calculated per 1,000 of Estimated Population. Note.—The deaths to be included in Column 7 of this table are the whole of those registered during the year as having actually occurred within the district or division. The deaths to be included in Column 12 are the number in Column 7, corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the term "Non-residents" is meant persons brought into the district on account of illness, and dying there ; and by the term "Residents" is meant persons who have been taken out of the district on account of illness, and have died elsewhere. Total Population at all ages 52,4361 Area of District in acres (exclusive of Number of Inhabited Houses 8,627 At Census of 1891. area covered by water), 3,388 Average number of Persons per house 6.00 74 Table II. Births and Deaths in Plumstead from 1896 to 1900. Names of Localities. West Plumstead. East Plumstead. Year. Population estimated to middle of each Year. Births Registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each Year. Births Registered. Deaths at all Ages. Deaths under 1 year. 1896 16714 486 214 48 42538 1464 788 216 1897 16993 469 229 45 44178 1506 700 185 1898 17100 453 276 79 45503 1443 740 217 1899 17465 452 259 45 47790 1519 657 200 Averages of Years 1896 to 1899 1900 17820 421 265 42 50278 1573 793 217 Table III. Cases of Infectious Disease notified during the Year 1900. Notifiable Disease. Cases notified in whole District. Total Cases notified in each Locality. No. of Cases Removed to Hospital from each Locality. At all Ages. At Ages—Years. West Plumstead East Plumstead West Plumstead East Plumstead Under 1. 1 to 5 5 to 15 Over 15. Small Pox .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. Diphtheria 237 3 94 120 20 68 169 62 155 Membranous Croup 3 1 2 1 2 .. .. Erysipelas 73 4 2 7 60 21 52 .. .. Scarlet Fever 300 2 90 173 35 55 245 47 199 Typhus Fever .. .. .. .. .. .. .. .. .. Enteric Fever 39 .. 1 11 27 4 35 1 27 Relapsing Fever .. .. .. .. .. .. .. .. .. Continued Fever 2 .. .. .. 2 1 1 .. 1 Puerperal Fever 4 .. .. .. 4 3 1 .. .. Plague .. .. .. .. .. .. .. .. .. Totals 658 10 189 311 148 153 505 110 393 75 Notes.—The localities adopted for this table should be the same as those in Tables II. and IV. State the name of the isolation hospital, if any, used by the sick of the district. Mark (H) the locality in which it is situated, or if not within the district state where it is situated and in what district. Table IV. Deaths at various ages, from different causes, corrected for Public Institutions inside and outsde the District. Causes of Death. Ages at Death. In Sub-Districts. In Public Institutions. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- All Ages. West Plumstead East Plumstead Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 11 32 3 .. .. .. .. .. .. .. .. .. .. 46 9 37 1 Scarlet Fever .. 3 1 .. .. 1 .. .. .. .. .. .. .. 5 1 4 3 Epidemic Influenza 1 .. .. .. .. .. 2 2 1 3 7 12 3 31 10 21 8 Whooping Cough 9 16 2 .. .. .. .. .. .. .. .. .. .. 27 8 19 .. Diphtheria and Mem. Croup .. 14 9 1 .. .. .. .. .. .. .. .. .. 24 7 17 20 Croup .. 1 1 .. .. .. .. .. .. .. .. .. .. 2 .. 2 .. Enteric Fever .. .. .. 1 1 1 3 2 1 .. .. .. .. 9 2 7 2 Asiatic Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea, Dysetery 30 4 .. .. .. .. .. .. .. .. 2 .. .. 36 15 21 .. Epidemic or Zymotic Enteritis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteritis 20 4 .. .. .. .. .. .. .... .. 1 .. 25 1 24 .. Other Continued Fevers .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rheumatism 1 .. .. 3 1 2 .. 1 .. .. .. .. .. 8 .. 8 2 Erysipelas .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 1 Puerperal Fever .. .. .. .. .. .. 2 .. .. .. .. .. .. 2 1 1 1 Other Septic Diseases .. .. .. 1 .. .. .. 1 1 3 .. .. .. 6 1 5 4 Intermittent Fever and Malarial Cachexia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tuberculosis of Meninges 2 1 2 .. 1 .. 1 .. 1 .. .. .. .. 8 3 5 .. Tuberculosis of Lungs .. 2 3 4 7 13 27 23 9 6 7 .. .. 101 21 80 24 Other Forms of Tuberculosis 15 9 2 .. 2 .. 1 .. .. 1 .. .. .. 30 2 28 3 76 Table IV.—Continued. Causes of Death. Ages at Death. In Sub-Distbicts. In Public Institutions. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- All Ages. West Plumstead East Plumstead Alcoholism .. .. .. .. .. .. .. .. 1 2 1 .. .. 4 2 2 1 Cancer .. .. .. .. 2 .. 1 9 12 14 15 4 .. 57 22 35 13 Premature Birth 28 .. .. .. .. .. .. .. .. .. .. .. .. 28 4 24 .. Developmental Diseases 54 9 1 .. .. .. .. .. .. .. .. .. .. 64 8 56 .. Old Age .. .. .. .. .. .. .. .. .. 2 9 21 6 38 10 28 11 Meningitis 1 2 2 .. 1 .. 1 .. .. .. .. .. .. 7 1 6 3 Inflammation and Softening of Brain .. .. 1 .. .. .. .. 1 .. 1 .. .. .. 3 1 2 3 Organic Diseases of Heart 1 .. 3 3 .. 6 1 10 16 16 17 4 .. 77 24 53 11 Acute Bronchitis 23 12 2 .. .. .. 2 1 .. 5 7 10 3 65 12 53 4 Chronic Bronchitis 1 .. .. .. .. .. .. .. .. 5 7 4 .. 17 5 12 2 Lobar (Croupous) Pneumonia 1 1 1 1 3 1 6 3 8 6 7 1 .. 39 11 28 11 Lobular (Bronclia) Pneumonia 17 17 1 .. .. .. .. .. 2 2 1 4 .. 44 11 33 1 Diseases of Stomach 2 .. .. .. 1 .. 1 .. .. .. .. .. .. 4 1 3 .. Obstruction of Intestines 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. Cirrhosis of Liver .. .. .. .. .. .. .. 4 5 3 .. .. .. 12 1 11 4 Nephritis and Bright's Disease .. .. .. .. .. 1 .. 1 5 6 5 .. .. 18 8 10 3 Tumours and other Affections of Female Genital Organs .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Accidents and Diseases of Parturition .. .. .. .. 1 1 7 2 .. .. .. .. .. 11 4 7 .. Deaths by Accident or Negligence 6 2 1 .. .. .. 2 2 3 1 2 3 .. 22 9 13 7 Deaths by Suicide .. .. .. .. .. .. 2 1 .. 1 .. .. .. 4 .. 4 .. Deaths from Ill-defined Causes 8 3 .. .. .. 1 2 2 2 3 6 2 .. 29 9 20 1 All other Causes 29 9 3 2 2 4 12 14 20 18 22 18 .. 153 41 112 34 Totals 261 141 38 16 22 31 74 79 87 98 115 84 12 1058 265 793 178 77 Table V. Eates per 1,000 Persons on the Population, estimated to the Middle of the Year. Year. Small Pox. Cholera. Erysipelas. Diphtheria and Membranous Croup. Scarlet Fever. Typhus Fever. Enteric and Continued Fevers. Relapsing Fever. Puerperal Fever. Cases. Deaths. Cases. Deaths, j Cases. Deaths. Oases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. 1890 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1891 0.01 .. .. .. 0.55 0.07 0.7 0.11 1.1 0.01 .. .. 0.45 0.07 .. .. 0.07 0.04 1892 .. .. .. .. 1.01 0.11 2.0 0.70 10.8 0.46 .. .. 0.40 0.05 .. .. 0.13 0.01 1893 0.90 0.03 .. .. 1.66 0.07 3.2 1.17 9.5 0.56 .. .. 0.52 0.14 .. .. 0.09 0.05 1894 0.38 0.03 0.01 0.01 1.12 0.01 2.0 0.59 8.4 0.37 .. .. 0.45 0.10 .. .. 0.03 0.05 1895 0.29 0.03 .. .. 0.91 0.01 2.5 0.58 5.6 0.17 .. .. 3.67 0.51 .. .. 0.12 0.07 1896 0.05 .. .. .. 0.72 0.05 3.3 1.00 5.8 0.23 .. .. 0.48 0.06 .. .. 0.05 0.02 1897 .. .. 0.06 .. 0.75 0.03 2.2 0.39 6.0 0.09 .. .. 0.40 0.04 .. .. 0.04 0.01 1898 .. .. 0.04 .. 0.86 0.03 1.7 0.24 6.7 0.18 .. .. 0.44 0.03 .. .. 0.11 0.11 1899 0.98 0.03 2.8 0.24 10.9 0.09 .. .. 0.38 0.01 .. .. 0.07 0.03 1900 .. .. .. 1.07 0.01 3.52 0.33 4.4 0.04 .. .. 0.57 0.13 .. .. 0.05 0.04 78 Table VI. Ages, Schools, and other particulars of the cases of SCARLET FEVER AND DIPHTHERIA. Total Cases. AGES. SEX. Houses with 1 Case only. Houses with 2 Cases. Houses with 3 Cases. Houses with 4 Cases or more. No. treated in Hospital Under 1 1 to 5 5 to 10 10 to 15 Over 15 Males. Females SCARLET FEVER 300 2 90 109 64 35 160 140 203 30 9 2 246 DIPHTHERIA AND MEMBRANOUS CROUP 240 4 94 86 34 22 109 131 162 25 2 4 217 79 Number of Patients attending each School. Ancona Road. Earl Street. Vicarage Road. Plumstead Road. Purrett Road. Bloomfield Road. The Slade. Burrage Grove Eglinton Road. High Street. Conway Road. Knee Hill, Abbey Wood Plum Lane. Other Schools. Total. On Roll 1316 On Roll 1025 On Roll 1048 On Roll 881 On Roll 1268 On Roll 1920 On Roll 1006 On Koll 976 On Roll 1292 On Roll 1211 On Roll 1357 On Koll 155 On Roll 396 SCARLET FEVER 25 22 12 8 15 9 13 16 3 12 27 0 6 19 187 DIPHTHERIA AND MEMBRANOUS CROUP 16 8 5 4 5 16 2 18 0 3 11 31 4 11 134 Table VII. Summary of the Vital Statistics of the Parish of Plumstead, 1885-1900. Year. Estimated Population middle of year. Births. Deaths. Annual Rate per 1000 living. Deaths from Principal Zymotic Disease. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus. Enteric Fever Simple and Undefined Fever. Diarrhoea. Phthisis. Other Tuberculous Disease. Deaths of Children under 1 year of age to 1000 births. Births. Deaths. Principal Zymotic Disease. 1885 40,354 1390 607 34.4 15.1 1.71 69 3 14 2 4 27 .. 5 .. 14 .. .. 120 1886 42,235 1609 735 38.2 17.5 2.64 111 .. 48 2 11 12 .. 3 1 34 .. .. 124 1887 44,204 1667 714 37.8 16.2 2.36 104 2 22 2 11 32 .. 2 .. 33 .. .. 116 1888 46,264 1703 689 36.9 14.9 1.58 73 .. .. 3 19 33 .. 2 .. 16 .. .. 112 1889 48,420 1852 759 38.4 15.7 2.03 98 .. 43 5 13 1 4 .. 2 .. 21 69 .. 115 1890 50,676 1933 923 37.5 17.9 2.47 127 .. 33 11 14 44 1 2 .. 22 95 .. 137 1891 52,754 1867 920 35.3 17.4 1.57 83 .. 33 1 6 24 .. 4 .. 15 114 .. 124 1892 54,060 1932 849 35.7 15.7 2.48 136 .. 19 25 38 29 .. 3 .. 22 100 .. 108 1893 55,398 1914 994 34.5 17.9 3.71 211 2 47 31 65 23 .. 8 .. 35 111 49 140 1894 56,770 1910 736 33.6 12.9 2.06 123 2 20 21 34 30 .. 6 .. 10 70 25 94 1895 58,175 1866 930 32.0 15.9 2.5 153 2 24 10 34 5 .. 30 .. 48 96 26 134 1896 59,615 1950 931 32.7 15.6 3.5 213 .. 68 14 60 35 .. 4 .. 30 81 26 133 1897 61,090 1975 835 32.3 13.6 2.2 138 .. 3 6 24 21 .. 3 .. 81 96 26 116 1898 62,603 1896 1016 30.2 16.2 3.5 224 .. 59 12 15 31 .. 2 .. 105 88 30 156 1899 65,255 1971 916 30.2 14.0 1.3 121 .. 3 6 16 10 .. 1 .. 85 95 24 124 1900 68,098 1994 1058 29.3 15.5 2.4 167 .. 46 3 23 28 .. 9 .. 58 101 38 129 80 81-2 Table VIII. Analysis of the Vital and Mortal Statistics of the Sanitary Districts of the Metropolis, after Distribution of Deaths occurring in Public Institutions during the year 1900. Sanitary Areas. Estimated Population in the middle of 1900. Births. Deaths. Annual Rate per 1000 living. Deaths from Principal Zymotic Diseases Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus. Enteric Fever. Simple and undefined Fever. Diarrhoea. Phthisis. Deaths of Children under 1 year of age to 1000 births. Births. Deaths. Principal Zymotic Diseases. London 4,589,129 130,868 83,732 28.6 18.3 2.19 10,034 4 1,928 361 1,539 1,945 2 716 7 3,532 7,809 158 West Districts. Paddington 130,134 2,891 2,069 22.3 15.9 1.72 222 - 50 5 27 35 1 8 1 95 149 165 Kensington 173,603 3,586 2,730 20.7 15.8 1.66 286 - 98 4 27 33 — 17 197 104 180 Hammersmith 110,203 2,994 1,887 272 17.2 2.23 247 - 90 7 28 10 — 17 95 185 162 Fulham 136,383 4,524 2,350 33.3 17.3 2.86 387 - 81 23 66 54 — 18 145 210 147 Chelsea 96,715 2,235 1,732 23.2 18.0 1.77 170 - 33 7 18 18 — 19 75 165 149 St. George's,Hanover Sq. 81,133 1,295 1,119 16.0 13.8 0.78 63 - 6 6 11 11 1 11 17 110 197 Westminster 51,657 1,058 1,062 20.5 20.6 1.46 75 - 20 1 8 15 — 9 22 124 189 St. James', Westminster 21,457 409 344 19.1 16.1 1.08 23 — 6 1 4 2 - 3 7 35 154 North Districts. Marylebone 139,777 3,991 2,627 28.6 18.9 1.86 259 2 49 12 40 55 - 12 1 88 278 125 Hampstead 81,766 1,621 922 19.9 11.3 1.18 96 — 21 4 31 9 — 9 22 69 100 St. Pancras 245,651 6,447 4,639 26.3 18.9 2.35 580 — 126 10 72 105 — 64 1 202 472 160 Islington 351,541 9,253 5,723 26.4 16.3 1.90 667 1 161 25 105 147 — 49 1 178 556 145 Stoke Newington 35,718 775 449 21.8 12.6 1.43 51 — 2 4 14 11 — 6 14 37 108 Hackney 225,519 6,373 3,624 28.3 16.1 2.11 476 — 33 19 59 112 — 43 210 260 158 Central Districts. St. Giles 36,870 1,017 671 27.7 18.2 1.67 61 - 11 4 8 14 - 5 19 110 118 St. Martin-in-the-Fields 11,865 155 209 13.1 17.7 0.84 10 — — — 2 1 — 3 4 28 148 Strand 22,748 445 464 19.6 20.5 1.14 26 — 5 1 3 5 - 4 8 74 135 Holborn 29,188 732 770 25.2 26.5 2.37 69 — 21 4 5 11 - 4 24 83 240 Clerkenwell 66,007 1,963 1,413 29.8 215 2.71 179 — 39 10 18 52 — 6 54 169 167 St. Luke 40,655 1,821 1,085 44.9 26.8 325 132 — 30 2 13 35 - 6 46 128 138 London City 26,922 397 591 14.8 22.0 0.89 24 — 4 5 6 3 — 2 4 67 176 East Districts. Shoreditch 120,641 4,004 2,604 33.3 21.6 3.02 364 - 76 16 57 48 - 14 1 152 224 186 Bethnal Green 128,831 4,588 2,822 35.7 22.0 2.76 355 — 63 12 63 94 — 18 105 272 168 Whitechapel 82,220 2,902 1,589 35.4 19.4 1.73 142 — 31 11 19 23 — 9 49 189 139 St. George-in-the-East 48,875 2,175 1,187 44.6 24.4 2.61 127 — 20 6 14 27 — 10 50 128 162 Limehouse 58,944 1,839 1,534 31.3 26.1 4.10 241 — 83 13 17 56 — 7 65 145 228 Mile End Old Town 113,781 4,261 2,311 37.6 20.4 2.53 288 — 60 7 35 58 — 22 106 193 158 Poplar 170,968 5,923 3,803 34.7 22.3 3.34 569 — 78 8 115 104 — 47 217 305 192 South Districts. St. Saviour Southwark 23,854 700 600 29.4 25.2 2.93 70 10 15 12 6 27 74 197 St. George Southwark 60,597 2,093 1,652 34.6 27.3 3.53 213 — 36 11 23 43 — 12 88 221 209 Newington 125,138 4,173 2,727 33.4 219 2.85 355 — 70 11 70 65 — 21 118 276 171 St. Olave Southwark 10,909 400 231 36.8 21.2 1.85 20 _ 5 1 3 8 — — 3 29 120 Bermondsey 85,920 2,826 1,948 33.0 22.7 3.24 277 — 42 7 59 64 — 27 78 169 186 Rotherhithe 41,246 1,184 883 28.8 21.5 3.40 140 — 40 6 26 22 — 10 36 47 205 Lambeth 312,152 9,167 5,431 29.4 17.4 1.66 519 — 69 21 101 98 — 53 1 176 521 145 Battersea 178,100 5,161 2,985 29.1 16.8 2.34 415 — 78 11 34 108 — 32 152 262 159 Wandsworth 217,004 5,774 3,204 26.7 14.8 1.65 361 — 82 17 44 44 — 27 1 146 252 144 Camberwell 268,457 7,211 4,372 26.9 16.3 1.99 534 — 40 12 132 122 — 33 195 370 154 Greenwich 184,582 5,562 3,305 30.2 18.0 2.27 418 — 58 15 64 111 — 23 147 274 161 Lee 40,722 990 615 24.4 15.1 1.40 57 — 5 19 9 — 4 20 39 156 Lewisham 93,548 2,784 1,469 29.8 15.7 2.14 200 20 9 32 49 — 14 76 104 131 Woolwich 41,600 1,175 915 28.3 22.1 2.79 116 — 29 6 7 15 — 3 55 106 173 Plumstead 68,098 1,994 1,058 29.3 15.5 2.30 150 46 5 24 27 9 36 101 129 ' 83 Table IX. Abstract from Mortuary Register for 1900. Date. Age. Sex. Inquest or no. Post Mortem or no. Cause of Death. 4tli Jan. 68 years M Yes Yes Apoplexy „ 13 days M Yes Yes Convulsions „ 56 years F Yes Yes Fatty degeneration of heart; syncope 9th ,, .. M Yes No Accidental death 10th „ 7 months F Yes Yes Congestion of lungs 10th „ 86 years F Yes No Influenza and bronchitis, caused by a fall 13th ,, 28 „ M Yes Yes Heart disease 23rd ,, 2 days M .. .. Accidental suffocation 30th „ 86 years F Yes No Senile decay 30th „ 38 „ F Yes Yes Carbolic poisoning 7th Feb 4 „ M Yes No Accidental burns 16th ,, 4 months M Yes .. Natural causes 16th „ 68 years F Yes No Accidental burns 16th ,, 45 „ M Yes Yes Death accelerated by alcoholism 17th „ 48 „ F Yes Yes Death accelerated by alcoholism 2nd Mar 12 hours M Yes Yes Accidental suffocation 14th ,, 57 years M Yes Yes Heart disease 27th „ 79 „ M Yes No Shock from fall while intoxicated 27th „ 14 days F Yes Yes Accidental suffocation 27th „ 56 years F Yes Yes Concussion following accidental fall down stairs while intoxicated 2nd April .. M Yes Yes Convulsions 2nd „ 16 months M Yes .. Shock following accidental burns 3rd „ 69 years M Yes No Accidental death 5th ,, 13 „ F Yes No Shock following accidental burns 5th ,, 7 months F Yes Yes Convulsions 5th ,, 69 years F Yes No Shock following accidental fall 20th ,, 5 F Yes Yes Abscess on left of brain 22nd ,, 81 „ M Yes No 29th „ M Yes No Found drowned 24th May 34 years F Yes Yes Heart Disease 24th 11 M Yes No Shock following accidental burns 14th June 2 months M Yes No Accidental suffocation from overlaying. 25 th „ 19 years M Yes No Accidentally drowned in a collision with the Bostonian Steamer. 28th „ 30 „ M Yes No Syncope from delirium tremens. 14th „ 70 „ M No No Natural Causes. 19th July 26 „ M No No Consumption. 19th „ 43 „ F No No 21st „ 79 „ M No No Senile decay. 30th „ 79 „ F Yes No (Old age) Shock following fall by being knocked down by a bicycle. F 84 Table IX.—continued. Date. Age. Sex. Inquest or no. Post Mortem or no. Cause of Death. 2nd Aug. 20 years F No No Scarlet Fever 4th „ 5 months F Yes Yes Inflammation of the stomach, terminating in convulsions 6th „ 84 years F Yes No Injury to left hip ; result of a fall 14th „ 6 weeks M Yes Yes Congestion of left lung 14th „ 9 months M Yes No Shock from burns 16th „ .. .. Yes Yes Syncope from heart disease catarrh of the stomach and bowels 17th „ 38 years F Yes Yes Exhaustion from delirium tremens 22nd „ 72 „ F No No Failure of the heart's action 9th Sept 29 „ M Yes No Suicide during temporary insanity 13th „ 110/12 F Yes Yes Congestion of lungs 15th „ 52 „ F No No Heart disease and dropsy 18th ,, 36 ,, M Yes No Delirium tremens and pneumonia 24th ,, 47 „ F Yes Yes Syncope from hemorrhage 25th ,, 38 ,, M Yes Yes Hemorrhage into the pericardium 27th „ 65 „ M No No 2nd Oct. 55 ,, 51 No No Apoplexy 7th „ 56 „ M Yes No Suicide during temporary insanity; asphyxia from hanging 8th ,, 60 „ M Yes Yes Consumption 19th „ 19 „ M No No Consumption 2nd Nov. 58 ,, M No No Natural causes 13th ,, 11 months F Yes Yes Inflammation of lungs 19th „ 59 years M Yes Yes Acute bronchitis and Bright's disease 1st „ 32/12 „ M Yes No Shock following accidental burns 23rd „ 12 hours M Yes Yes Convulsions 23rd „ 76 years F Yes Yes Heart disease; fracture of the right hip bone, the result of a fall in Bethnal Green ; death being accelerated by the fall 26th „ 29 „ M Yes Yes Apoplexy following lead poisoning; cerebral hemorrhage 27th „ 13 „ M Yes Yes Convulsions 28th „ 11 days F Yes Yes Pneumonia 3rd Dec. 7 months M Yes Yes Pneumonia 3rd ,, 39 years M Yes No Bronchitis, pneumonia, and chronic alcoholism 10th „ 3 months M Yes Yes Accidental suffocation from overlaying 16th „ 33 years F Yes Yes Suicide whilst mentally deranged by perforating the peritoneum with a cane 26th „ 4 weeks F Yes Yes Asphyxia 27th „ 81 years M Yes Yes Paralysis of the brain 27th ,, 58 „ F Yes Yes Syncope from heart disease 85 Table X. Summary of Nuisances abated, Notices served, and General W ork of the Public Health Department for the 12 months ended 31st December, 1900. West District Inspector. Central District Inspector. South District Inspector. East District Inspector. Total PREMISES INSPECTED. No. of Houses inspected, house to house 794 773 720 418 2705 ,, Re-inspections after service of notices 1565 1890 1580 1625 6660 ,, Houses and Premises specially inspected, including infectious diseases and complaints 776 851 888 1005 3520 „ Houses where drains have been tested by smoke test 75 57 48 55 235 ,, Houses where drains have been tested by water 41 27 26 28 122 NUISANCES ABATED. Drains. Waste pipes from baths, lavatories and washhouse sinks, repaired or disconnected .. 25 24 23 26 98 Choked and defective drains 97 190 98 114 499 Defective traps 19 7 12 26 64 Defective and unventilated soil pipes.. 19 16 16 4 55 W.C.'s W.C.'s repaired, new traps or pans provided, fittings repaired 132 144 144 162 582 Water supply apparatus repaired 120 105 112 126 463 F 2 86 Table X.—continued. Premises. West District Inspector. Central District Inspector. South District Inspector. East District Inspector. Total Interiors cleansed, repaired, and defective roofs repaired 292 197 429 148 1066 Damp walls remedied 48 73 147 44 312 Paving in yards and wash-houses repaired 113 59 66 76 314 Through ventilation provided 10 14 12 7 43 Wash-houses without sinks and outlets for waste water 11 1 .. .. 12 Defective guttering and rain-water pipes 67 188 46 82 383 Dustbins supplied 32 86 13 50 181 Dung pits provided 2 3 .. 1 6 Cases of overcrowding remedied 6 20 17 18 61 Animals. Animals kept in such a state as to be a nuisance 4 2 2 4 12 Accumulations of manure removed 17 4 1 7 29 Water. Defective and foul cisterns used for dietary purposes 4 1 2 7 Defective and foul rain-water tanks remedied 13 •• 2 .. 15 Defective water pipes, rendering premises damp 23 9 7 13 52 Insufficient supply, and water cut off by Water Company 12 3 17 3 35 87 Table X.—continued. SUMMARY OP CHIEF INSPECTOR, Premises inspected 910 Premises inspected in which various sanitary defects were found 855 New buildings inspected for which certificates were issued for efficient water supply 417 Ditches cleansed 19 Defective combined drains investigated and reported upon 43 Number of houses referred to in such combined drains 222 Cowhouses and Slaughterhouses inspected 13 Obstructions on footpaths dealt with 23 Attendances at Police Court 29 MISCELLANEOUS, INCLUDING WORK OP CHIEF INSPECTOR, DISTRICT INSPECTORS, AND CLERKS. Number of cases of inattention to notices reported to Vestry Clerk for proceedings 85 Summonses at the Police Court Bakehouses cleansed twice during the year Number of houses disinfected after infectious diseases 694 „ cases disinfected for other parishes (Lee and Eltham) to 8th 41 Letters received 1405 ,, written 1709 Notifications received 658 Certificates issued after disinfection 1454 ,, of infectious diseases forwarded to schools 1219 Complaints of Sanitary defects 318 „ non-removal of dust 535 Written Intimation Notices 2017 Statutory Notices 330 88 TABLE XI. Prosecutions under Public Health Department. Date. Offence. Situation. Result. 1900. February 1 Nuisance 46, Conway Road Withdrawn by order of Public Health Committee March 8 Occupying house without water certificate 21, Bostal Hill Fined 7/-, and 2/- costs „ 8 Letting house without water certificate 52, Wickham Lane Fined 2/6, and 2/- costs „ 29 Nuisance 8, Mineral Street Order to abate in 7 days, and 3/- costs May 17 Defective yard paving 123, Plumstead Road Work done, 2/- costs paid „ 17 Nuisance 122, „ „ „ 3/- „ „ 17 Defective flushing apparatus 9,Bannockburn Road Adjourned to 30 May; work done 2/- costs paid „ 30 Defective drains (M.M.A.) The Lodge, casual & receiving wards Workhouse Adjourned to 20th June again adjourned to 18th July, again adjourned to 1st August, when fines amounting to £100, and £5 5s., costs imposed „ 30 Defective drains(P.H(L)A.) 105. Princes Road Order to abate in 7 days, and 6/- costs June 20 Letting house without water certificate 2, Woodhurst Road Fined 20/-, and 2/- costs „ 20 Ditto 12, Bastion Road Fined 20/-, and 2/- costs „ 20 Nuisance 2, Stevens Cottages, Barnfield Road Order to abate, and 13/- costs „ 20 Ditto 3, ditto Order to abate, and 3/-costs July 18 Letting house without water certificate Woodhurst Road Fined 40/-, and 2/- costs Sept. 27 Not complying with notice to repair drains 1 to 8, St. Margaret's Road, even numbers Adjourned 4 weeks,25th Oct. Adjourned to 8th Nov. „ 27 Nuisances 10, Hanover Road Order to abate in 7 days, and 3/- costs „ 27 „ 5, Coupland Terrace Work done 3/- costs paid „ 27 „ 9. „ „ Work done, 3/- costs paid „ 27 „ 11. „ „ Adjourned to 18th October „ 27 „ „ 33, Walmer Road Work done 3/- costs paid Table XII. Particulars of Adulterations and Results of Proceedings, 1st January, 1900, to 31st December, 1900. No. Article. Result of Analysis. Name and Address of Vendor Date of Hearing. Result of Summonses Remarks. 1900 Fined Costs Sample sent to Somerset House, whose certificate said 16 per cent, fat extracted 3 Milk 10 per cent, fat abstracted W. G. Elliott, 239, High Street 8th Feb. 10/- & 12/6 7 Milk 10 per cent, fat abstracted F. G. Cock, 13, Raglan Road . bth ,, 20/- & 12/6 19 Milk 10 per cent, fat abstracted James Taylor, 68, Walmer Road 8th Mar. 40/- & 12/- 20 Milk 13 per cent, fat abstracted Margaret Goddard, 6, Westdale Road 8 th „ 15/- & 12/- 40 Milk 16 per cent, added water Charles Jones, 6, Florence Terrace 29th ,, 40/- & 12/- Milk 93 per cent, fat abstracted John Thompson, 10, Kenwood Avenue 10th May 40/- & 2/- or 7 days Milk 10 per cent, fat abstracted H. Brooks, 2, Richmond Place 5th July 40/- & 2/- Milk 10 per cent, fat abstracted J. Holdway, 7, Florence Terrace 18th „ 5/- & 12/6 Milk 14 per cent, added water A. P. Godden, 229, High Street 2nd Aug. 40/- & 12/6 Milk 22 per cent, added water F. G. Cock, 13, Raglan Road 18th Oct. £4 & 12/6 Butter 1/8 butter, 7/8 margarine John Rees, 17, Lakedale Road 31st „ £4 & 12/6 Butter 3/5 butter, 2/5 margarine Edward Burton, 2, Admaston Road 31st ,, 5/- & 12/6 Refusal to serve milk Richard Still, 65, Vicarage Road 8th Feb. 20/- & 2/- „ George Lambeth, 2, Griffin Road 17th May £5 & 2/- or 1 month Obstructing Food & Drugs Miss C. W. Lambeth, 2, Griffin Road 31st Oct. £2 & 3/- ,, [Inspector Mrs. M. Lambeth, 2, Griffin Road 31st „ £3 & 2/- „ Frank Lambeth, 2, Griffin Road 31st „ £4 & 2/- 89 90 Table XIII. List of Enteric Fever Cases, 1900. No. Street. Date. Age. Sex. Remarks. l 10, Bostal Hill 17th Feb. 30 F. Nurse at West Ham Infirmary; was nursing enteric when she left a month ago. 2 75, Earl Street 19th „ 25 F. Had oysters about amonth ago, aud frequently. 3 153, Sandy Hill Road 2nd Mar. 27 M. Employed in sighting room Royal Arsenal. Ate mussels not thoroughly boiled at end of January. 4 22, Pattison Road 12th „ 23 M. Employed at Brass Foundry,Royal Arsenal, when illness commenced. 5 43, Griffin Road 28th ,, 20 M. Works at Wandsworth. 6 12, Frederick Place 31st „ 30 M. Ate mussels on 10th. Works in Gun Factories. 7 87, High Street 2nd April 12 M. Goes about with greengrocer's cart. 8 22, Hartville Road 17th „ 3 M. 9 74, Glyndon Road 17 th ,, 24 F. 10 51, Bramblebury Rd. 12th May 13 F. Not been away from home, but had visited Herbert Hospital. 11 31, Whitworth Road 31st „ 38 M. Gardener employed Upper Eglinton Road. Visits Stratford Market daily. Had no shell fish. 12 99, Tewson Road 9th Aug. 24 M. Labourerin Royal Arsenal. 13 34, Maxey Road 14th ,, 10 F. Not been away or had shell fish 14 134, Ann Street 17th Sept, 35 F. Was at Hurst Park on Bank Holiday (6th Aug.), Had tea at Hampton Court. 15 1, Majendie Road 16th Oct. 16 M. Returned from Southsea three weeks before; ate winkles there. 16 153, Parkdale Road 20th „ 23 M. Works in Arsenal. 17 23, Benares Road 25th „ 10 F. Not enteric: gastro enteritis, lasting two days. 18 161, Reidhaven Rd. 31st „ 20 F. Dirty habits. 19 73, Tewson Road 1st Nov. 20 F. Had celery; delicate. 20 82, Roydene Road 5 th „ 33 M. Works in cordite factory. 91 Table XIII.—continued. No. Street. Date. Age. Sex. Remarks. 21 39, Park Road 6th Nov. 18 M. Football player. Been to Erith, Bexley, October. 22 35, Hargor Road 6th „ 23 F. Had whelks 13th October, mussels 15th October, at Soder's. 23 84, Barth Road 8th „ 24 F. Had whelks about 5th October at Soder's. 24 3, Florence Terrace 8th „ 17 M. Had celery beginning of October. 25 240, High Street 10th „ 6 F. Ill ten days; delicate child; not been away; no celery nor shell fish; shares lunch at school with other children; Gadbrook Dairy. 26 26, Reidhaven Road 15th „ 12 M. Very dirty house and drinking parents. 27 Dale View, Bostal Lane 17th „ 29 F. Had mussels from Soder's, Abbey Wood, two weeks before illness. 28 6, Hull Place 21st „ 15 F. Parents hawkers of shell fish 29 Bleak House, Bleak Hill 28th „ 22 M. Fireman on s,s. Fellinore, came home on 10th. 30 55, Villas Road 3rd Dec. 10 F. Had celery several times. 31 64, Roydene Road 10th „ 11 M. 32 8, Hcverham Road.. 13th „ 32 M. Policeman. Frequently have celery. 33 „ „ 13th „ 27 F. 34 „ „ 13th ,, 5 F. 35 41, Garland Street 13th „ 15 M. Had shell fish on Sunday previous to being ill. Works in R. A. 36 The Infirmary 20th ,, 8 M. Been in Infirmary for ringworm since October. 37 55, Villas Road 22nd,, 12 M. Had celery several times. Was nursing sister, No. 109. 38 1, Liffler Road 24th „ 23 M. Barman,"Anglesea Arms," New Road, Woolwich. 39 33, Benares Road .. 26th „ 47 F. Had oysters, 5th inst. 92 Table XIV. List of Bake-houses. No. Name. Address. l W. Jefferey 123, Burrage Road 2 W. Rose 57, Burrage Road 3 J. Farrier 30, Burrage Road 4 W. T. Akers 16, Armstrong Place 5 J. H. Dalton 13, Eton Road 6 H. W. Blacknell 12, Spray Street 7 W. Arnold 57, Plumstead Road 8 J. Fletcher 92, Plumstead Road 9 E. Page 109, Plumstead Road 10 J. Tait 136, Plumstead Road 11 J. Clarke 152, Plumstead Road 12 A. V. Chapman 2, High Street 13 R. Moakes 51, Parkdale Road 14 0. Degen 20, Conway Road 15 A. F. Jewis 68, Glyndon Road 16 F. Phillips 53, Ann Street 17 F. Grant 102, Ann Street 18 T. Maynard 64, Villas Road 19 J.Werner 1, Park Road 20 J. T. Alderton 81, Park Road 21 Mrs. S. Medcraf 58, Pattison Road 22 E. Plummer 46, Hudson Road 93 • Table XIV.—List of Bake-houses—continued. No. Name. Address. 23 J. Allway 126, High Street 24 H. Percival 223, High Street 25 The Guardians Woolwich Union 26 J. Porter 1, Riverdale Road 27 Goddard & Co. 14, Gunning Street 28 F. Hallam 307, High Street 29 C. Betchley 33, Eglinton Road 30 Mrs. Colver 165, Sandy Hill Road 81 Merritt & Co. 50, Herbert Road 32 Mrs. S. Fuller 48, Princes Road 33 Cliadwell Brothers 60, Plumstead Common Road 34 R. C. Davis 2, Crescent Road 35 W. H. Hughesdon 24, St. James' Place 36 R. Gilder 14, Westdale Road 37 C. Pullen 105, Plumstead Common Road 94 Appendix I. Report on the area embracing Barnfield Place, Barnfield Road, Princes Road, Brookhill Row, Portland Place and May Place. This is an area in the South-west part of Plumstead, consisting largely of some of the oldest houses in the parish. The population as obtained by a house to house inspection was 960 consisting of 305 adult males, 310 adult females, and 439 children under 10 years of age. ' There are 187 houses, containing 807 rooms and 215 families. There are thus 5'1 persons to a house, 1*2 persons to a room. The adjoining Table A gives the principal vital statistics, Table B giving a comparison with Plumstead and Reidhaven Road. Of the 187 houses in the district I inspected 153, with the following result. No separate water supply 13 No separate W.C. 10 Insufficient air space in front 3 ,, „ behind 5 Dilapidations 43 Dirty rooms or passage 79 Overcrowding 25 Damp walls 30 Rooms dark or insufficiently ventilated 13 Defective "W.C.s 28 Stopped drains 2 Indecency of sleeping arrangements 7 Yards unpaved or insufficiently paved 11 Rain water pipes and gutters defective 9 Accumulations—offensive 2 Dark and unventilated staircases 2 Dirty tenants 3 These defects have for the most part been remedied; the 8 houses with insufficient air space in front or behind could only be treated by closing order, and I did not think their condition bad enough to justify this. 95 The northern half of Barnfield Road is too narrow to be healthy, and is also improperly paved. An improvement scheme here is very desirable, but the area is not bad enough to be dealt \vith by closing order. Table BJshows that although the general death rate and deaths per 1000 births are higher than in the Reidhaven Road District, the diarrhcea rate is decidedly lower, which agrees with the opinion I have given that the soil on which the former area is built is a principal cause of its unhealthiness. On the other hand the deaths from alcoholism per cent, of total deaths are much higher in the Princes Read area, and probably alcoholism aggravating and causing other diseases is a principal cause of the high mortality in this area, and is doubtless connected with the fact that the area has five public houses within 2 minutes walk of its centre. Frequent inspections of this district have been made for years, but a lady sanitary inspector or health visitor might do a great deal that a male inspector cannot do, towards reducing the high infantile mortality. Unfortunately the Council has no powers which will enable it directly to deal with intemperance. Table A. Pbinces Road Area. Vital Statistics for 1897-8-9. Number of Deaths. Year. Total. Under 1 year. 1-5 Diph. Entrc. Diarrhoea. Phthisis. Other Tuber. Dis'se. Alcoholism. 1897 23 5 4 1 2 2 3 1898 24 11 3 1 3 1899 22 7 2 4 4 1 1 Total 69 23 9 6 9 3 4 Average. 23 7.6 3 2 3 1 1.3 96 Population 960 Houses 187 Persons to a House 5.1 Rooms 807 Persons to a Room 1.2 Total Births—97-99 108 Average 36 Average Deaths 23 Average under 1 year 7.6 Birth Rate 37.5 Death Rate 23.9 Deaths under 1 year per 1000 Births 211 Notifications, Diphtheria 6 [Thrice as much as Plumstead). Death Rate for Phthisis 31 TABLE B. Summary of Vital Statistics for Princes Road Area compared with Reidhaven Road Area and Plumstead. Average for the years '97, '98, '99. Reidhaven Road Area. Princes Road Area. Plumstead Birth Rate per 1000 population 38.5 37.5 30.9 Death Rate 18.5 23.9 14.6 Deaths under 1 year per 1000 births 169 211 132 Diarrhoea Death Rate per 1000 population 3.2 2.0 1.4 Phthisis ,, ,, ,, 2.1 3.1 1.4 Alcoholism per cent of deaths 5.5 35 Persons to a house 6.5 5.1 6.33 97 TABLE C. Death Statistics. Armstrong Street, Armstrong Place, and Whitworth Place. Number of Deaths. Year. Total. Under 1. 1-5. Diphtheria. Enteric. Diarrhoea. Phthisis. 1897 17 7 1 5 1898 14 2 2 1 1899 11 4 2 1 2 Total 42 13 5 7 2 Average 14 4.3 1.6 2.3 .6 Houses 86 Rooms 457 Persons to a House 6.7 „ „ Room 12 Population 580 Average Births for 3 years, 1897-9 25 Average Deaths 14 Average Deaths under 1 Year 4.3 Average Deaths from Diarrhcea 2 Average Deaths from Phthisis 1 Birth Rate 43.1 Death Rate 24-1 Deaths under 1 Year per 1,000 Births 172 Notifications of Diphtheria 2 98 Appendix II. METROPOLITAN BOROUGH OP WOOLWICH. Uncertified Deaths and Death Registbation. Report of Medical Officer of Health on the action taken by the late Plumstead Vestry with respect to uncertified deaths and death registration, with a summary of the replies received from other Sanitary Authorities (referred to in Public Health Committee's Report of 11th December, 1900, paragraph 12.) The Public Health Committee of the late Plumstead Vestry, in April last, had under consideration the matter of death certification, and in connection therewith a Report of the London County Council Control Committee of January, 1895, as to uncertified deaths and Coroner's Inquests, and recommendations of a Select Committee of the House of Commons, 1893, on the subject. Asa result—' (a) The Local Government Board was asked to introduce into Parliament, without further delay, a Bill on the lines proposed by the Select Committee of the House of Commons on the subject of death registration, and, (b) A letter was sent to all the Vestries and District Boards of the Metropolis, and to the London County Council, in the following terms:— " The Medical Officer of the Parish of Plumstead having reported as to the high percentage of uncertified deaths in Plumstead (averaging 3'5 in the last three years), the Vestry has had Tinder consideration the unsatisfactory state of the law with respect to death certification, more especially as it effects the registration of uncertified deaths. "The Vestry finds that the number of inquests held varies much at the discretion of the Coroner of the district, the uncertified deaths being in some places less than 1 per cent., and in Plumstead as much as 3 to 4 per cent, in recent years; that the enquiries which enable the Coroner to decide whether or not an inquest shall be held, and determine the cause of death when no inquest is held, are made by a police constable not specially qualified for this responsible duty. "A Select Committee of the House of Commons enquired into the whole subject of death registration in 1893, and made numerous recommendations. "A Committee of the London County Council also enquired into the same subject, and endorsed the recommendations of the Select Committee. (See report of London County Council on Coroners' Law Amendment and Payment of Jurors, January, 1895.) 99 "The Vestry considers that a Bill on the lines proposed by the Select Committee should be introduced into Parliament without further delay, and intends to memorialize the president of the Local Government Board to that effect. They consider that the objects to be aimed at are the prevention of crime, and the more exact ascertaining of the cause of death for statistical purposes, and that for these ends the following are the most important reforms demanded:— 1. Medical certificates to be forwarded direct to the Registrar. 2. The fact of death to be certified by the medical man. 3. That qualified medical investigators should be appointed to enquire into all uncertified deaths, make post mortems when required, and report to the Coroner. 4. That in no case should a death be registered without the production of a certificate signed either by a registered medical practitioner or by a Coroner, after satisfactory enquiries by the medical investigator or after'inquest. "The Vestry asks you to join in memorializing the Local Government Board in favour of legislation on the lines proposed by the Select Committee of the House of Commons, 1893." Up to this date replies have been received from 24 Authorities. 20 of which concur in the proposed memorial, and 4 resolved to take no action. The replies received are summarised as follows •— Chelsea Vestry. Agree that the present state of the law with regard to death certification is unsatisfactory, and transmit a copy of a report by their Medical Officer of Health with respect to the matter, copies of which have been sent to the Local Government Board, London County Council, and the Local Authorities on the South side of the River Thames. St. John's Vestry, Support the action taken by the Plumstead Hampstead, Vestry. St. Luke's Vestry. Agree with the opinion expressed in the communication. St. Pancras Vestry. Have decided to memorialize the Local Government Board in favour of legislation on the lines proposed by the Select Committee of the House of Commons, 1893. Lee District Board No action taken. of Works. Holborn District Approve the action of the Plumstead Vestry and Board of Works. will memorialise the Local Government Board accordingly. G 2 100 Wandsworth District Board of Works. The number of uncertified deaths in this District is exceedingly small, but it any alteration in the law be required, it should, in their opinion, be in accordance with the recommendations of the Select Committee of the House of Commons, who investigated the question of death registration in 1893. St. Mary's Vestry, Newington. Passed a resolution concurring in the views of the Plumstead Vestry, although the matter is one which does not materially affect this Parish, as the percentage of uncertified deaths is very low. St. George-in-the-East Vestry. Agree with the views expressed in the letter. Lewisham District Board of Works. Concur in the views expressed by the Plumstead Vestry contained in the suggestions Nos. 3 and 4, and are prepared to join in memorialising the Local Government Board in this direction. St. Margarets and St. John's Vestry, Westminster. Receipt of the letter respectfully acknowledged. St. Mary Abbott's Vestry Kensington. Decided to take no action in the matter, although there was some feeling that the present state of things should be amended. Bermondsey Vestry. Resolved to join in the proposed memorial to the Local Government Board. St. Giles' District Board of Works. Addressed a communication to the Local Government Board in favour of Legislation on the lines proposed by the Select Committee of the House of Commons on the subject of Death Registration in the Session of 1893. Battersea Vestry. Addressed a communication to the Local Government Board in support of the views expressed by the Plumstead Vestry. St. Marylebone Vestry. Receipt of letter simply acknowledged. St. Mary's Vestry, Stoke Newington. Resolved to accede to the request contained in the letter of the Plumstead Vestry, and addressed a letter to the Local Government Board on the subject. St. Olaves District Board of Works. The Board concurred with the Plumstead Vestry in memorialising the Local Government Board on the subject, on the lines proposed by the Select Committee of the House of Commons, 1893. Limehouse District Board of Works. Approved the proposals referred to in the and the Local Government Board was in] accordingly. St. James' & St. John's Vestry, Clerkenwell. Is prepared to support the memorial to the Local Government Board upon the subject. 101 Camberwell Vestry. Agreed with the views of the Plumstead Vestry and asks for a copy of the Memorial in order to take similar action. St. Mary's Vestry, Islington. Is in accord with the views expressed in the letter, and has communicated with the Local Government Board, urging them to promote legislation on the lines indicated by the Plumstead Vestry. Lambeth Vestry. Passed the three following resolutions on the subject :— (1) Medical certificates to be forwarded direct to the Registrar. (2) The fact of death to be certified by the medical man. (3) In no case should a death be registered without the production of a certificate, signed either by the registered medical practitioner, or by a Coroner. St. George's Vestry, Hanover Square. Resolved that the four following requirements should be put most prominently forward, and addressed a letter to the Local Government Board on the subject. (1) That Medical Practitioners should be required to send certificates of deaths to the Registrar, so that he shall receive the same within 24 hours from the time of death, instead of handing them to the representative of the deceased. (2) That a Medical Practitioner in attendance should be required before giving a certificate of death, to personally inspect the body and identify it as the body of the person he has attended. (3) That certified Medical Practitioners should appointed to enquire into all uncertified deaths, make post mortems when required, and report to the Coroner. (4) That in no case should a death be registered without production of a certificate of the cause of death, signed either by a registered Medical Practitioner, or by a Coroner after satisfactory enquiries by the Medical investigator or inquest. SIDNEY DA VIES, M.A., M.D. Oxon., D.P.H. Cam., Medical Officer of Health. G 102 To the Chairman and.Members of the Public Health Committee of the Metropolitan Borough of Woolwich. Gentlemen, la accordance with your order I beg to hand in my report on the Public Health of the Eltham District during the year 1900. 1. There were 134 births, giving a rate of 22'67 per 1,000 inhabitants. This is reckoned on the enumeration of 1896, and is probably smaller owing to increase of population. 2. The deaths registered in the district amounted to 79, and 19 were reported from " Outlying Institutions," making 98 in all. 3. Prom these 6 deaths of persons dying in the district but not belonging to it have to be deducted, leaving the corrected total at 92. This number gives a death-rate of 15 58 per 1,000 inhabitants. 4. The real death-rate is probably smaller than 15'58 on account of considerable increase in the population since 1896. 5. Zymotic Disease.—There were two deaths only from notifiable Zymotic Disease, both from Diphtheria, one at home and one at Brook Hospital. Death-rate, '33 per thousand. 6. Prom non-notifiable Zymotic Disease 14 deaths were reported, 4 due to Influenza in the first quarter, and 10 to Diarrhoea in young children during two consecutive weeks in September. 7. Porty-seven new cases were notified, and the great majority of them was removed to Hospital. They were as under:— Scarlet Fever 22 Diphtheria 18 Enteric Fever 4 Puerperal Fever 1 Erysipelas 2 Total 47 103 8. Scarlet Fever.—There was no regular epidemic and no death. In some cases it was impossible to trace the sources of contagion. 9. Diphtheria.—Here again there was no epidemic, but in several instances groups of children were infected before medical aid was sought. 10. In connection with the increase of infectious disease in this district in the autumn, I wish to point out that many tramps pass through it, and in doing so sleep and rest in the fields. Children playing in the same fields apparently become infected. 11. When once medical aid had been called in and the case isolated there was no further spread. 12. Enteric Fever.—Four cases were notified, all contracted outside the district, and none ending fatally. 13. General Health.—The general health of the district has been good with the exception of the infant mortality in September. This seems to have been due to indifferent feeding rather than bad hygienic surroundings. 14. The Bakehouses.—The Bakehouses have all been inspected twice during the year, and were found to be clean and in good order. 15. Slaughter-hotises, Milkshops, and Dairy Farms.—Once also the Slaughterhouses, Milkshops, and Cowsheds were inspected after being handed over by the L.C.C. on November 9th. 16. Over-crowding.—One case of overcrowding in Kirk's Yard was investigated and put right. I have the honour to be, Gentlemen, Your obedient servant, EDWARD J. MOORE, D.P.H, Table I. Name op District.—Eltham. For whole District. Year. 1 Population estimated to middle of each year. 2 Births. Deaths under One Year, of Age. Deaths at all Ages. Total. Deaths in Public Institutions. 9 Deaths of Nonresidents registered in District. 10 Deaths of residents registered beyond District. 11 Deaths at all Ages. Nett. Number. 3 Rate* 4 Number, 5 Rate per 1000 Births registered. 6 Number. 7 Rate* 8 Number. 12 Rate* 13 1891 5682 142 24.9 9 63.3 58 10.2 10 .. .. 68 11.9 1892 5736 126 21.9 16 126.9 66 11.5 11 .. .. 77 13.4 1893 5840 135 23.1 — — 81 13.8 12 . . .. 81 13.8 1894 5890 129 21.9 14 108.5 62 10.5 14 1 .. 75 12.7 1895 5938 132 22.2 17 128.7 64 10.7 14 1 2 79 13.3 1896 5911 130 21.9 23 176.9 75 12.6 16 5 1 87 14.7 1897 6091 125 29.5 15 120 76 12.4 16 7 2 87 14.2 1898 6192 120 19.3 18 150 71 11.4 17 4 .. 84 13.5 1899 6351 136 21.4 27 198.5 93 14.6 14 5 .. 102 16.05 Averages for years 1891-1899. 5959 130 21.9 17 119.2 71 11.8 13 3.7 1.6 82.2 13.7 1900 +6340 134 21.1 21 134.3 79 12.4 19 6 92 14.5 104 *Rates calculated per 1,000 of estimated Population. Note.—The deaths to be included in Column 7 of this table are the whole of those registered during the year as having actually occurred within the district or division. The deaths to be included in Column 12 are the number in Column 7, corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the term "Non-residents" is meant persons brought into the district on account of illness, and dying there ; and by the term "Residents" is meant persons who have been taken out of the district on account of illness, and have died elsewhere. Area of District in acres (exclusive of Total Population at all ages 5,682 Number of inhabited houses 1,025 A Census of 1891. area covered by water), 3782. Ayerage number of persons per house 5.5 † This is estimated Population. Impossible to get an idea of real Population till Census. 105 Table II. Names of Localities. Eltham. Year. Population estimated to middle of each Year. Births Registered. Deaths at all Ages. Deaths under 1 year. 1890 .. .. .. .. 1891 5682 142 68 9 1892 5736 126 77 16 1893 5840 135 81 .. 1894 5890 129 75 14 1895 5938 132 79 17 1896 5911 130 87 23 1897 6091 125 87 15 1898 6192 120 84 18 1899 6351 136 102 27 Averages of Years 189 to 1899. 5959 130 822 17 1900 6340 134 92 21 106 Table III. Cases of Infectious Disease notified during the year 1900. Notifiable Disease. Cases notified in Whole District. No. of Cases removed to Hospital. At all Ages. At Ages—Years. Under 1 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards Small-pox .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. Diphtheria 18 .. 7 9 1 1 .. 7 Brook Hospital, Kidbrooke Membranous Croup .. .. .. .. .. .. .. .. Erysipelas 2 .. .. .. .. 2 .. .. Scarlet Fever 22 .. 2 14 4 2 .. 15 Typhus Fever .. .. .. .. .. .. .. .. Enteric Fever 4 .. .. 1 2 1 .. 4 Relapsing Fever .. .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. Puerperal Fever 1 .. .. .. .. 1 .. .. Plague .. .. .. .. .. .. .. .. Totals 47 — 9 24 7 7 — 26 107 Table IV. District.—Eltham. Causes of, and Ages at, Death during Year 1900. Cause of Death. Deaths in whole District at subjoined ages. Deaths in Public Institutions. All ages. Under 1 1 and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards Small-pox • • • • • • • • • • • • • • • • Measles • • • • • • • • • • • • • • • • Scarlet fever.. • ♦ • • • • • • • • • • • • • • Wliooping-cough • • • • • • • • • • • • • • • • Diphtheria and membranous croup 2 • • 2 • • • • • • • • 1 Croup • • • • • • • • • • • • • • • • Fever Typhus • • • • • • • • • • • • • • • • Enteric • • • • • • • • • • • • • • • • Other cont'd • • • • • • • • • • • • • • • • Epidemic Influenza 2 • • • • • • • • • • • • • • Cholera • • • • • • • • • • • • • • • • Plague • • • • • • • • • • • • • • • • Diarrhoea 11 10 • • • • • • • • 1 • • Enteritis 1 • • • • • • • • • • 1 • • Puerperal fever • • • • • • • • • • • • • • • • Erysipelas • • • • • • • • • • • • • • • • Other septic diseases • • • • • • • • • • • • • • • • Phthisis 6 • • • • • • 1 4 1 1 Other tubercular diseases 1 • • 1 • • • • • • • • • • Cancer, malignant disease 5 • • • • • • • • 3 2 l Bronchitis 13 1 • • • • • • 7 5 2 Pneumonia 8 • • 2 • • • • 5 1 2 Pleurisy 1 • • • • • • 1 • • • • • • Other diseases of • • • • • • • • • • • • • • • • piratory organs • • • • • • • • • • • • • • • • Alcoholism • • • • • • • • • • • • • • • • Cirrhosis of Liver Venereal Diseases • • • • • • • • • • • • • • • • Premature birth 4 • • • • • • • • • • • • • • Diseases & accidents of parturition • • • • • • • • • • • • • • • • Heart diseases 10 • • • • • • • • • • 3 • • Accidents 3 • • • • • • 2 • • 1 • • Suicides 1 • • • • • • • • 1 • • • • All other causes 30 5 • • • • 7 3 15 10 All Causes 98 21 5 2 11 28 31 19 108 Table V. List of Bake-houses and Cow-houses in Eltham. BAKE-HOUSES. Situation. Occupier. 94, High Street Charles Tertius Hill 114 „ Ellen Edith Seriven 77 „ Richard Humphrey 142 „ Frederick John Cook 5a, Brentwood Cottages, Footseray Road 13, The Parade, Footseray Road Arthur Thornton Storror Phillip Hughes 5 „ „ Charles Worboys COW-HOUSES. Situation. Occupier. Lyme Farm W. F. Corp Middle Park Maurice Bailey Park Farm John & Alfred Low Pippin Hall John Grace Keightly House, Southwood Road Richard Pace Clay Farm Richard Higgs Coldharbour Farm Richard Higgs Belmont Park Farm E. Fisher & Sons Southend Hall Henry Furber Chapel Farm William Ridewood